Pharmacotherapy for Pregnant Women with Opioid Use Disorder
Ahra Kim, MPH
14 January 2026
1 Introduction
This project focuses on Analysis 2 of the Study Protocol, which aims to characterize pregnant individuals with OUD and examine hazards of maternal death and overdose. A poster was presented at Academy Health annual research meeting focusing on analysis on those with OUD and at least one day of MOUD prescription. (Section 7)
1.1 Methods
Data Source
- TennCare data
- TN all payer hospitalization database
- Birth and death certificates
- US Census data
Inclusion Criteria
- Women 15-44 years old
- Delivery of an infant >=20 weeks between 2007-2020
- Continuous enrollment in TennCare from 90 pre-delivery through 41 days post partum
- No sickle cell disease or active malignancy
- With and without MOUD receipt initially, but only included those with MOUD for main analysis
- Up to 5-days gap of continuous enrollment
- Exposure: Days of MOUD supply between -90 days prior to delivery and +41 days post-delivery (maximum number of days = 132)
- Covariates also collected during exposure period
- Outcomes: first event of either overdose or death from 42 days post-delivery
Statistical analysis
Descriptive statistics were computed using frequencies (proportions) and medians (IQRs) as appropriate for the overall sample and also stratified by timing of MOUD receipt. Timing of MOUD receipt variable was categorized relative to timing of delivery and has two levels: receipt during one period only either pre- or post-delivery or receipt during both pre- and post-delivery periods. Due to the low number of outcomes, several variables were collapsed into one. These variables are listed below.
- Route of delivery: Cesarean or Vaginal (Vaginal + Forcep + Vacuum)
- Pain conditions: Back pain + dental pain + fibromyalgia + indicator for NSAIDs
- Alcohol use disorder + other substance use
- Benzodiazepine + Anticonvulsant use
- Anxiety + Depression
Total days of MOUD receipt was calculated using three different methods. Method 1 sums the days supply variable (“daysup”) and if the pre-delivery period number is greater than 90 days, then it is capped at 90. Similarly, this method caps the post-delivery days supply to 42. Numerical example:
studyid from_day daysup total.rx.days
96 002007060499-05446655-02100650 -106 14 14
97 002007060499-05446655-02100650 -106 14 28
98 002007060499-05446655-02100650 -105 14 42
99 002007060499-05446655-02100650 -94 30 72
100 002007060499-05446655-02100650 -93 30 90
101 002007060499-05446655-02100650 -64 1 90
102 002007060499-05446655-02100650 -63 30 90Pre-delivery days of MOUD is calculated as 90 for this individual.
Method 2 also sums the days supply variable, but the number of days over 90 is added to the post-delivery period. Method 2 caps the pre-delivery days to 90 and the post delivery days to 42. Numerical example below:
studyid from_day daysup total.rx.days
96 002007060499-05446655-02100650 -106 14 14
97 002007060499-05446655-02100650 -106 14 28
98 002007060499-05446655-02100650 -105 14 42
99 002007060499-05446655-02100650 -94 30 72
100 002007060499-05446655-02100650 -93 30 102
101 002007060499-05446655-02100650 -64 1 103
102 002007060499-05446655-02100650 -63 30 133Pre-delivery days of MOUD is calculated as 90 for this individual, and the additional 43 days are carried over to the post-delivery period. However, the post-delivery days supply is capped to 42.
Method 3 was used in the conference abstract, as it was the most conservative approach. This method counts for overlapping prescription dates using the “from_day” variable, which is the number of days anchored from Day 42 of the exposure period (e.g. from_day -132 is the first day of the exposure period), and sums the number of days covered. Days supply greater than 90 in the pre-period is carried onto the post-delivery period but overlapping prescription dates are not counted. Numerical example below:
studyid daysup from_day
96 002007060499-05446655-02100650 14 -106
97 002007060499-05446655-02100650 14 -106
98 002007060499-05446655-02100650 14 -105
99 002007060499-05446655-02100650 30 -94
100 002007060499-05446655-02100650 30 -93
101 002007060499-05446655-02100650 1 -64
102 002007060499-05446655-02100650 30 -63 studyid pre_days_covered carryover_days
17 002007060499-05446655-02100650 64 9For this individual, 64 days are counted starting from Day -106 to -43 days and 9 carryover days are counted into the post-delivery period.
After calculating the number of days of MOUD receipt, various histograms were plotted to examine differences by method. Then, multivariable Cox Proportional hazards model were used to determine the associations between total days of MOUD receipt as the main exposure and death or overdose as the outcome. For individuals with multiple outcomes, the earliest outcome was used. Outcomes that occurred during the follow-up period were counted if they were captured in the TN all payer database if an individual lost eligibility for TennCare. Average dose per day of MOUD receipt (qty*dose)/(days supply) was also calculated and described in the table. Average days supply and dose from the pre-delivery period that exceeded 90 days was carried over and added to the post-delivery period.
The Cox model was first modeled using linear continuous terms, due to the limited degrees of freedom. However, year of delivery was determined to be non-linear and was modeled using a restricted cubic spline with 3 knots. These models included the following covariates: year of delivery, total day MOUD receipt, age at delivery, gestation weeks, route of delivery, combined pain conditions, alcohol/other substance use, benzodiazepine/anticonvulsant use, anxiety/depression, maternal morbidity (CDC defined). Additional covariates were included initially but were removed due to the small number of outcomes. These include race/ethnicity combined, number of previous pregnancies, schizophrenia/personality disorder, CDC social vulnerability index, and timing of MOUD receipt (one or two periods relative to delivery). Robust standard errors clustered at the individual level were computed.
Future analyses planned: + Repeat analysis excluding those who received naltrexone and methadone + Include individuals with the exposure period starting at 180 days before delivery + Include individuals with up to 30-days gap in enrollment
Additonal notes: few outcomes (<5) prior to 2015
2 Descriptive Statistics (90 days pre-delivery & up to 5 days loss enroll)
2.1 Demographics/Clinical Characteristics
2.1.1 Column percents
- There are 15103 pregnancies in 12532 unique individuals
| N | No MOUD | MOUD | Test Statistic | |
|---|---|---|---|---|
| (N=7631) | (N=7472) | |||
| Year of delivery | 15103 (100.00) | F1,15101=1238.74, P<0.00013 | ||
| Median (interquartile range) | 2014 (2011—2017) | 2016 (2014—2018) | ||
| Range | 2007—2020 | 2007—2020 | ||
| Age at delivery | 15103 (100.00) | F1,15101=79.02, P<0.00013 | ||
| Median (interquartile range) | 27 (23—30) | 27 (24—31) | ||
| Range | 15—44 | 17—44 | ||
| Number of Gestation weeks | 15103 (100.00) | F1,15101=97.93, P<0.00013 | ||
| Median (interquartile range) | 38 (37—39) | 39 (37—39) | ||
| Range | 22—43 | 21—42 | ||
| Race | 15099 (99.97) |
Χ2 4=212.83, P<0.00012 |
||
| American Indian or Alaska Native | 21/7627 (0.28) | 23/7472 (0.31) | ||
| Asian or Pacific Islander | 14/7627 (0.18) | 11/7472 (0.15) | ||
| Black of African American | 617/7627 (8.09) | 210/7472 (2.81) | ||
| Other or Unknown | 86/7627 (1.13) | 53/7472 (0.71) | ||
| White | 6889/7627 (90.32) | 7175/7472 (96.03) | ||
| Hispanic : Not Hispanic | 15089 (99.91) | 7534/7624 (98.82) | 7398/7465 (99.10) |
Χ2 1=2.93, P=0.08682 |
| Race/Ethnicity combined | 15103 (100.00) |
Χ2 4=209.22, P<0.00012 |
||
| Hispanic | 90/7631 (1.18) | 67/7472 (0.90) | ||
| Non-Hispanic Asian | 13/7631 (0.17) | 11/7472 (0.15) | ||
| Non-Hispanic Black | 613/7631 (8.03) | 209/7472 (2.80) | ||
| Non-Hispanic Other | 74/7631 (0.97) | 55/7472 (0.74) | ||
| Non-Hispanic White | 6841/7631 (89.65) | 7130/7472 (95.42) | ||
| Route of delivery : Vaginal | 15103 (100.00) | 4966/7631 (65.08) | 4857/7472 (65.00) |
Χ2 1=0.01, P=0.92412 |
| Number of previous pregnancies | 14869 (98.45) | F1,14867=6.63, P=0.01003 | ||
| Median (interquartile range) | 2 (1—3) | 2 (1—3) | ||
| Range | 0—24 | 0—23 | ||
| Final outcome | 15103 (100.00) |
Χ2 3=411.87, P<0.00012 |
||
| Death | 47/7631 (0.62) | 30/7472 (0.40) | ||
| Overdose | 84/7631 (1.10) | 97/7472 (1.30) | ||
| Loss of enrollment | 1629/7631 (21.35) | 709/7472 (9.49) | ||
| Censored | 5871/7631 (76.94) | 6636/7472 (88.81) | ||
| Final outcome (w/o all payer data) | 15103 (100.00) |
Χ2 3=409.14, P<0.00012 |
||
| Death | 19/7631 (0.25) | 11/7472 (0.15) | ||
| Overdose | 77/7631 (1.01) | 91/7472 (1.22) | ||
| Loss of enrollment | 1664/7631 (21.81) | 734/7472 (9.82) | ||
| Censored | 5871/7631 (76.94) | 6636/7472 (88.81) | ||
| Total days supplied MOUD | 15103 (100.00) | F1,15101=93419.74, P<0.00013 | ||
| Median (interquartile range) | 0 (0—0) | 96 (56—120) | ||
| Range | 0—112 | 1—132 | ||
| Total days supplied MOUD before delivery | 15103 (100.00) | F1,15101=46301.24, P<0.00013 | ||
| Median (interquartile range) | 0 (0—0) | 74 (35—90) | ||
| Range | 0—84 | 0—90 | ||
| Total days supplied MOUD after delivery | 15103 (100.00) | F1,15101=24424.08, P<0.00013 | ||
| Median (interquartile range) | 0 (0—0) | 30 (9—42) | ||
| Range | 0—28 | 0—42 | ||
| Total days supplied MOUD (method 2) | 15103 (100.00) | F1,15101=93814.73, P<0.00013 | ||
| Median (interquartile range) | 0 (0—0) | 98 (56—125) | ||
| Range | 0—112 | 1—132 | ||
| Total days supplied MOUD before delivery (method 2) | 15103 (100.00) | F1,15101=46301.24, P<0.00013 | ||
| Median (interquartile range) | 0 (0—0) | 74 (35—90) | ||
| Range | 0—84 | 0—90 | ||
| Total days supplied MOUD after delivery (method 2) | 15103 (100.00) | F1,15101=27941.69, P<0.00013 | ||
| Median (interquartile range) | 0 (0—0) | 30 (14—42) | ||
| Range | 0—28 | 0—42 | ||
| Total days supplied MOUD (method 3) | 7472 (49.47) | |||
| Median (interquartile range) | — | 89 (47—112) | ||
| Range | — | 1—132 | ||
| Total days supplied MOUD before delivery (method 3) | 7472 (49.47) | |||
| Median (interquartile range) | — | 62 (30—78) | ||
| Range | — | 0—90 | ||
| Total days supplied MOUD after delivery (method 3) | 7472 (49.47) | |||
| Median (interquartile range) | — | 30 (13—40) | ||
| Range | — | 0—42 | ||
| Avg dose pre-delivery (mg) | 7394 (48.96) | |||
| Median (interquartile range) | — | 14.24 (8.00—16.00) | ||
| Range | — | 0.00—50.00 | ||
| Avg dose post-delivery (mg) | 7394 (48.96) | |||
| Median (interquartile range) | — | 9.72 (4.00—16.00) | ||
| Range | — | 0.00—53.57 | ||
| Avg dose exposure (mg) | 7394 (48.96) | |||
| Median (interquartile range) | — | 14.09 (9.42—16.00) | ||
| Range | — | 0.14—53.57 | ||
| Total days buprenorphine before delivery (method 3) | 7299 (48.33) | |||
| Median (interquartile range) | — | 63.00 (30.00—78.00) | ||
| Range | — | 0.00—90.00 | ||
| Total days buprenorphine after delivery (method 3) | 7299 (48.33) | |||
| Median (interquartile range) | — | 30.00 (13.00—41.00) | ||
| Range | — | 0.00—42.00 | ||
| Total days supplied buprenorphine | 7299 (48.33) | |||
| Median (interquartile range) | — | 90.00 (49.00—112.00) | ||
| Range | — | 1.00—132.00 | ||
| Avg dose BUP pre-delivery (mg) | 7298 (48.32) | |||
| Median (interquartile range) | — | 14.12 (8.00—16.00) | ||
| Range | — | 0.00—35.42 | ||
| Avg dose BUP post-delivery (mg) | 7298 (48.32) | |||
| Median (interquartile range) | — | 9.71 (4.00—16.00) | ||
| Range | — | 0.00—42.67 | ||
| Avg dose BUP exposure (mg) | 7298 (48.32) | |||
| Median (interquartile range) | — | 13.98 (9.13—16.00) | ||
| Range | — | 0.14—42.67 | ||
| Combined pain : Yes | 15103 (100.00) | 6000/7631 (78.63) | 5766/7472 (77.17) |
Χ2 1=4.67, P=0.03082 |
| Schizophrenia or personality disorder : Yes | 15103 (100.00) | 598/7631 (7.84) | 583/7472 (7.80) |
Χ2 1=0.01, P=0.93802 |
| Alcohol or other substance use : Yes | 15103 (100.00) | 4490/7631 (58.84) | 3342/7472 (44.73) |
Χ2 1=301.15, P<0.00012 |
| Benzodiazepine or anticonvulsant use : Yes | 15103 (100.00) | 996/7631 (13.05) | 1077/7472 (14.41) |
Χ2 1=5.91, P=0.01502 |
| Maternal morbidity : Yes | 15103 (100.00) | 776/7631 (10.17) | 528/7472 (7.07) |
Χ2 1=46.07, P<0.00012 |
| Anxiety and depression combined : Yes | 15103 (100.00) | 2987/7631 (39.14) | 3485/7472 (46.64) |
Χ2 1=86.67, P<0.00012 |
| Back pain : Yes | 15103 (100.00) | 3189/7631 (41.79) | 2528/7472 (33.83) |
Χ2 1=101.61, P<0.00012 |
| Depression : Yes | 15103 (100.00) | 2587/7631 (33.90) | 2946/7472 (39.43) |
Χ2 1=49.66, P<0.00012 |
| Bipolar disorder : Yes | 15103 (100.00) | 830/7631 (10.88) | 819/7472 (10.96) |
Χ2 1=0.03, P=0.86822 |
| Other substance use : Yes | 15103 (100.00) | 4363/7631 (57.17) | 3197/7472 (42.79) |
Χ2 1=312.63, P<0.00012 |
| Tobacco use : Yes | 15103 (100.00) | 5201/7631 (68.16) | 5196/7472 (69.54) |
Χ2 1=3.37, P=0.06652 |
| Med NSAIDS : Yes | 15103 (100.00) | 4754/7631 (62.30) | 4602/7472 (61.59) |
Χ2 1=0.80, P=0.36992 |
| Schizophrenia psychotic disorders : Yes | 15103 (100.00) | 398/7631 (5.22) | 466/7472 (6.24) |
Χ2 1=7.30, P=0.00692 |
| Anxiety : Yes | 15103 (100.00) | 1113/7631 (14.59) | 1608/7472 (21.52) |
Χ2 1=122.93, P<0.00012 |
| Med benzodiazepine use : Yes | 15103 (100.00) | 660/7631 (8.65) | 713/7472 (9.54) |
Χ2 1=3.65, P=0.05622 |
| Maternal morbidity : Yes | 15103 (100.00) | 776/7631 (10.17) | 528/7472 (7.07) |
Χ2 1=46.07, P<0.00012 |
| Dental pain : Yes | 15103 (100.00) | 410/7631 (5.37) | 298/7472 (3.99) |
Χ2 1=16.20, P=0.00012 |
| Alcohol use disorder : Yes | 15103 (100.00) | 502/7631 (6.58) | 507/7472 (6.79) |
Χ2 1=0.26, P=0.61062 |
| Med anticonvulsant use : Yes | 15103 (100.00) | 423/7631 (5.54) | 432/7472 (5.78) |
Χ2 1=0.40, P=0.52622 |
| Med muscle relaxant use : Yes | 15103 (100.00) | 649/7631 (8.50) | 371/7472 (4.97) |
Χ2 1=75.11, P<0.00012 |
| Personality disorder : Yes | 15103 (100.00) | 283/7631 (3.71) | 220/7472 (2.94) |
Χ2 1=6.85, P=0.00892 |
| Fibromyalgia : Yes | 15103 (100.00) | 555/7631 (7.27) | 383/7472 (5.13) |
Χ2 1=29.88, P<0.00012 |
| CDC SVI overall percentile ranking of all 4 themes | 14003 (92.72) | F1,14001=18.02, P<0.00013 | ||
| Median (interquartile range) | 0.60 (0.38—0.81) | 0.58 (0.37—0.79) | ||
| Range | 0.00—1.00 | 0.00—1.00 |
N is the number of non-missing value. 1Kruskal-Wallis.
2Pearson. 3Wilcoxon.
- Outlier with average dose of 16,000 due to quantity of (56,000 * 8mg)/28 days
2.1.2 Characteristics based on MOUD timing (method 3)
| N | No MOUD | Only pre | Only post | Both pre and post | |
|---|---|---|---|---|---|
| (N=7631) | (N=898) | (N=638) | (N=5936) | ||
| Year of delivery | 15103 (100.00) | ||||
| Median (interquartile range) | 2014 (2011—2017) | 2016 (2015—2018) | 2016 (2014—2019) | 2016 (2014—2018) | |
| Range | 2007—2020 | 2007—2020 | 2007—2020 | 2007—2020 | |
| Year of delivery as categorical | 15103 (100.00) | ||||
| 2007 | 284/7631 (3.72) | 1/898 (0.11) | 6/638 (0.94) | 25/5936 (0.42) | |
| 2008 | 312/7631 (4.09) | 3/898 (0.33) | 15/638 (2.35) | 41/5936 (0.69) | |
| 2009 | 467/7631 (6.12) | 10/898 (1.11) | 19/638 (2.98) | 52/5936 (0.88) | |
| 2010 | 478/7631 (6.26) | 6/898 (0.67) | 24/638 (3.76) | 112/5936 (1.89) | |
| 2011 | 554/7631 (7.26) | 19/898 (2.12) | 27/638 (4.23) | 146/5936 (2.46) | |
| 2012 | 611/7631 (8.01) | 28/898 (3.12) | 19/638 (2.98) | 223/5936 (3.76) | |
| 2013 | 595/7631 (7.80) | 40/898 (4.45) | 43/638 (6.74) | 438/5936 (7.38) | |
| 2014 | 659/7631 (8.64) | 79/898 (8.80) | 48/638 (7.52) | 684/5936 (11.52) | |
| 2015 | 690/7631 (9.04) | 121/898 (13.47) | 60/638 (9.40) | 821/5936 (13.83) | |
| 2016 | 769/7631 (10.08) | 155/898 (17.26) | 61/638 (9.56) | 769/5936 (12.95) | |
| 2017 | 667/7631 (8.74) | 124/898 (13.81) | 70/638 (10.97) | 635/5936 (10.70) | |
| 2018 | 610/7631 (7.99) | 125/898 (13.92) | 58/638 (9.09) | 621/5936 (10.46) | |
| 2019 | 552/7631 (7.23) | 113/898 (12.58) | 91/638 (14.26) | 663/5936 (11.17) | |
| 2020 | 383/7631 (5.02) | 74/898 (8.24) | 97/638 (15.20) | 706/5936 (11.89) | |
| Age at delivery | 15103 (100.00) | ||||
| Median (interquartile range) | 27 (23—30) | 27 (24—31) | 27 (24—31) | 27 (24—31) | |
| Range | 15—44 | 18—43 | 17—44 | 17—44 | |
| Number of Gestation weeks | 15103 (100.00) | ||||
| Median (interquartile range) | 38 (37—39) | 39 (37—39) | 38 (37—39) | 39 (37—39) | |
| Range | 22—43 | 24—42 | 23—42 | 21—42 | |
| Race | 15099 (99.97) | ||||
| American Indian or Alaska Native | 21/7627 (0.28) | 4/898 (0.45) | 3/638 (0.47) | 16/5936 (0.27) | |
| Asian or Pacific Islander | 14/7627 (0.18) | 1/898 (0.11) | 1/638 (0.16) | 9/5936 (0.15) | |
| Black of African American | 617/7627 (8.09) | 35/898 (3.90) | 22/638 (3.45) | 153/5936 (2.58) | |
| Other or Unknown | 86/7627 (1.13) | 11/898 (1.22) | 5/638 (0.78) | 37/5936 (0.62) | |
| White | 6889/7627 (90.32) | 847/898 (94.32) | 607/638 (95.14) | 5721/5936 (96.38) | |
| Hispanic : Not Hispanic | 15089 (99.91) | 7534/7624 (98.82) | 886/895 (98.99) | 633/637 (99.37) | 5879/5933 (99.09) |
| Race/Ethnicity combined | 15103 (100.00) | ||||
| Hispanic | 90/7631 (1.18) | 9/898 (1.00) | 4/638 (0.63) | 54/5936 (0.91) | |
| Non-Hispanic Asian | 13/7631 (0.17) | 1/898 (0.11) | 1/638 (0.16) | 9/5936 (0.15) | |
| Non-Hispanic Black | 613/7631 (8.03) | 34/898 (3.79) | 22/638 (3.45) | 153/5936 (2.58) | |
| Non-Hispanic Other | 74/7631 (0.97) | 13/898 (1.45) | 7/638 (1.10) | 35/5936 (0.59) | |
| Non-Hispanic White | 6841/7631 (89.65) | 841/898 (93.65) | 604/638 (94.67) | 5685/5936 (95.77) | |
| Route of delivery : Vaginal | 15103 (100.00) | 4966/7631 (65.08) | 614/898 (68.37) | 421/638 (65.99) | 3822/5936 (64.39) |
| Number of previous pregnancies | 14869 (98.45) | ||||
| Median (interquartile range) | 2 (1—3) | 2 (1—3) | 2 (1—3) | 2 (1—3) | |
| Range | 0—24 | 0—19 | 0—23 | 0—23 | |
| Final outcome | 15103 (100.00) | ||||
| Death | 47/7631 (0.62) | 3/898 (0.33) | 2/638 (0.31) | 25/5936 (0.42) | |
| Overdose | 84/7631 (1.10) | 19/898 (2.12) | 16/638 (2.51) | 62/5936 (1.04) | |
| Loss of enrollment | 1629/7631 (21.35) | 100/898 (11.14) | 90/638 (14.11) | 519/5936 (8.74) | |
| Censored | 5871/7631 (76.94) | 776/898 (86.41) | 530/638 (83.07) | 5330/5936 (89.79) | |
| Total days supplied MOUD | 15103 (100.00) | ||||
| Median (interquartile range) | 0 (0—0) | 30 (15—56) | 28 (14—33) | 108 (84—122) | |
| Range | 0—112 | 1—90 | 1—70 | 7—132 | |
| Total days supplied MOUD before delivery | 15103 (100.00) | ||||
| Median (interquartile range) | 0 (0—0) | 30 (15—56) | 0 (0—0) | 84 (60—90) | |
| Range | 0—84 | 1—90 | 0—28 | 1—90 | |
| Total days supplied MOUD after delivery | 15103 (100.00) | ||||
| Median (interquartile range) | 0 (0—0) | 0 (0—0) | 28 (14—33) | 30 (21—42) | |
| Range | 0—28 | 0—0 | 1—42 | 0—42 | |
| Total days supplied MOUD (method 2) | 15103 (100.00) | ||||
| Median (interquartile range) | 0 (0—0) | 30 (15—56) | 28 (14—33) | 112 (84—129) | |
| Range | 0—112 | 1—132 | 1—70 | 7—132 | |
| Total days supplied MOUD before delivery (method 2) | 15103 (100.00) | ||||
| Median (interquartile range) | 0 (0—0) | 30 (15—56) | 0 (0—0) | 84 (60—90) | |
| Range | 0—84 | 1—90 | 0—28 | 1—90 | |
| Total days supplied MOUD after delivery (method 2) | 15103 (100.00) | ||||
| Median (interquartile range) | 0 (0—0) | 0 (0—0) | 28 (14—33) | 35 (24—42) | |
| Range | 0—28 | 0—42 | 1—42 | 0—42 | |
| Total days supplied MOUD (method 3) | 7472 (49.47) | ||||
| Median (interquartile range) | — | 30 (14—49) | 14 (7—25) | 100 (76—116) | |
| Range | — | 1—89 | 1—41 | 7—132 | |
| Total days supplied MOUD before delivery (method 3) | 7472 (49.47) | ||||
| Median (interquartile range) | — | 30 (14—49) | 0 (0—0) | 69 (48—80) | |
| Range | — | 1—89 | 0—0 | 1—90 | |
| Total days supplied MOUD after delivery (method 3) | 7472 (49.47) | ||||
| Median (interquartile range) | — | 0 (0—0) | 14 (7—25) | 35 (23—41) | |
| Range | — | 0—0 | 1—41 | 1—42 | |
| Avg dose pre-delivery (mg) | 7394 (48.96) | ||||
| Median (interquartile range) | — | 13.90 (8.00—16.00) | 0.00 (0.00—0.00) | 15.00 (9.94—16.00) | |
| Range | — | 0.14—50.00 | 0.00—0.00 | 0.25—50.00 | |
| Avg dose post-delivery (mg) | 7394 (48.96) | ||||
| Median (interquartile range) | — | 0.00 (0.00—0.00) | 15.76 (8.12—16.00) | 12.00 (8.00—16.00) | |
| Range | — | 0.00—0.00 | 0.80—53.57 | 0.00—50.00 | |
| Avg dose exposure (mg) | 7394 (48.96) | ||||
| Median (interquartile range) | — | 13.90 (8.00—16.00) | 15.76 (8.12—16.00) | 14.04 (9.87—16.00) | |
| Range | — | 0.14—50.00 | 0.80—53.57 | 0.25—50.00 | |
| Total days buprenorphine before delivery (method 3) | 7299 (48.33) | ||||
| Median (interquartile range) | — | 30.00 (14.00—49.00) | 0.00 (0.00—0.00) | 69.00 (48.00—80.00) | |
| Range | — | 1.00—89.00 | 0.00—0.00 | 0.00—90.00 | |
| Total days buprenorphine after delivery (method 3) | 7299 (48.33) | ||||
| Median (interquartile range) | — | 0.00 (0.00—0.00) | 14.50 (7.00—25.00) | 35.00 (23.00—41.00) | |
| Range | — | 0.00—0.00 | 1.00—41.00 | 0.00—42.00 | |
| Total days supplied buprenorphine | 7299 (48.33) | ||||
| Median (interquartile range) | — | 30.00 (14.00—49.00) | 14.50 (7.00—25.00) | 100.00 (76.00—116.00) | |
| Range | — | 1.00—89.00 | 1.00—41.00 | 4.00—132.00 | |
| Avg dose BUP pre-delivery (mg) | 7298 (48.32) | ||||
| Median (interquartile range) | — | 13.33 (8.00—16.00) | 0.00 (0.00—0.00) | 14.86 (9.67—16.00) | |
| Range | — | 0.14—29.71 | 0.00—0.00 | 0.00—35.42 | |
| Avg dose BUP post-delivery (mg) | 7298 (48.32) | ||||
| Median (interquartile range) | — | 0.00 (0.00—0.00) | 15.30 (8.00—16.00) | 12.00 (8.00—16.00) | |
| Range | — | 0.00—0.00 | 0.80—42.67 | 0.00—33.24 | |
| Avg dose BUP exposure (mg) | 7298 (48.32) | ||||
| Median (interquartile range) | — | 13.33 (8.00—16.00) | 15.30 (8.00—16.00) | 13.98 (9.75—16.00) | |
| Range | — | 0.14—29.71 | 0.80—42.67 | 0.25—34.47 | |
| Combined pain : Yes | 15103 (100.00) | 6000/7631 (78.63) | 702/898 (78.17) | 473/638 (74.14) | 4591/5936 (77.34) |
| Schizophrenia or personality disorder : Yes | 15103 (100.00) | 598/7631 (7.84) | 83/898 (9.24) | 66/638 (10.34) | 434/5936 (7.31) |
| Alcohol or other substance use : Yes | 15103 (100.00) | 4490/7631 (58.84) | 441/898 (49.11) | 315/638 (49.37) | 2586/5936 (43.56) |
| Benzodiazepine or anticonvulsant use : Yes | 15103 (100.00) | 996/7631 (13.05) | 131/898 (14.59) | 87/638 (13.64) | 859/5936 (14.47) |
| Maternal morbidity : Yes | 15103 (100.00) | 776/7631 (10.17) | 69/898 (7.68) | 52/638 (8.15) | 407/5936 (6.86) |
| Anxiety and depression combined : Yes | 15103 (100.00) | 2987/7631 (39.14) | 403/898 (44.88) | 337/638 (52.82) | 2745/5936 (46.24) |
| Back pain : Yes | 15103 (100.00) | 3189/7631 (41.79) | 308/898 (34.30) | 190/638 (29.78) | 2030/5936 (34.20) |
| Depression : Yes | 15103 (100.00) | 2587/7631 (33.90) | 338/898 (37.64) | 294/638 (46.08) | 2314/5936 (38.98) |
| Bipolar disorder : Yes | 15103 (100.00) | 830/7631 (10.88) | 110/898 (12.25) | 61/638 (9.56) | 648/5936 (10.92) |
| Other substance use : Yes | 15103 (100.00) | 4363/7631 (57.17) | 434/898 (48.33) | 303/638 (47.49) | 2460/5936 (41.44) |
| Tobacco use : Yes | 15103 (100.00) | 5201/7631 (68.16) | 651/898 (72.49) | 428/638 (67.08) | 4117/5936 (69.36) |
| Med NSAIDS : Yes | 15103 (100.00) | 4754/7631 (62.30) | 551/898 (61.36) | 384/638 (60.19) | 3667/5936 (61.78) |
| Schizophrenia psychotic disorders : Yes | 15103 (100.00) | 398/7631 (5.22) | 64/898 (7.13) | 49/638 (7.68) | 353/5936 (5.95) |
| Anxiety : Yes | 15103 (100.00) | 1113/7631 (14.59) | 208/898 (23.16) | 140/638 (21.94) | 1260/5936 (21.23) |
| Med benzodiazepine use : Yes | 15103 (100.00) | 660/7631 (8.65) | 93/898 (10.36) | 56/638 (8.78) | 564/5936 (9.50) |
| Maternal morbidity : Yes | 15103 (100.00) | 776/7631 (10.17) | 69/898 (7.68) | 52/638 (8.15) | 407/5936 (6.86) |
| Dental pain : Yes | 15103 (100.00) | 410/7631 (5.37) | 44/898 (4.90) | 30/638 (4.70) | 224/5936 (3.77) |
| Alcohol use disorder : Yes | 15103 (100.00) | 502/7631 (6.58) | 66/898 (7.35) | 64/638 (10.03) | 377/5936 (6.35) |
| Med anticonvulsant use : Yes | 15103 (100.00) | 423/7631 (5.54) | 48/898 (5.35) | 33/638 (5.17) | 351/5936 (5.91) |
| Med muscle relaxant use : Yes | 15103 (100.00) | 649/7631 (8.50) | 57/898 (6.35) | 50/638 (7.84) | 264/5936 (4.45) |
| Personality disorder : Yes | 15103 (100.00) | 283/7631 (3.71) | 35/898 (3.90) | 31/638 (4.86) | 154/5936 (2.59) |
| Fibromyalgia : Yes | 15103 (100.00) | 555/7631 (7.27) | 55/898 (6.12) | 29/638 (4.55) | 299/5936 (5.04) |
| CDC SVI overall percentile ranking of all 4 themes | 14003 (92.72) | ||||
| Median (interquartile range) | 0.60 (0.38—0.81) | 0.61 (0.38—0.81) | 0.58 (0.37—0.78) | 0.57 (0.36—0.78) | |
| Range | 0.00—1.00 | 0.00—1.00 | 0.00—1.00 | 0.00—1.00 |
N is the number of non-missing value. 1Kruskal-Wallis.
2Pearson. 3Wilcoxon.
2.2 Histogram of MOUD days supplied
2.2.1 Before delivery up to 90 days (Method 1)
2.2.2 Before delivery up to 90 days (Method 2)
2.2.3 Before delivery up to 90 days (Method 3)
2.2.4 After delivery up to 41 days (Method 1)
2.2.5 After delivery up to 41 days (Method 2)
2.2.6 After delivery up to 41 days (Method 3)
2.2.7 Entire exposure (Method 1)
2.2.8 Entire exposure (Method 2)
2.2.9 Entire exposure (Method 3)
2.2.10 Entire exposure buprenorphine only (Method 3)
3 Survival Analysis
3.1 Kaplan Meier Plot by MOUD
3.2 Log-Rank Test
Call:
survdiff(formula = Surv(days.to.event, outcome.bin) ~ moud.yes,
data = basic)
N Observed Expected (O-E)^2/E (O-E)^2/V
moud.yes=0 7631 131 130 0.00421 0.00851
moud.yes=1 7472 127 128 0.00430 0.00851
Chisq= 0 on 1 degrees of freedom, p= 0.9 - There is a statistically significant difference in death or overdose between the two groups
3.3 Multivariable Cox PH model
3.3.1 Linear continuous terms
Effects Response: Surv(days.to.event, outcome.bin) | |||||||
| Low | High | Δ | Effect | S.E. | Lower 0.95 | Upper 0.95 | |
|---|---|---|---|---|---|---|---|
| Year of delivery | 2000.00 | 2000.00 | 2.0 | 0.380 | 0.100 | 0.180 | 0.580 |
| Hazard Ratio | 2000.00 | 2000.00 | 2.0 | 1.500 | 1.200 | 1.800 | |
| Total days supplied MOUD (method 3) | 1.00 | 31.00 | 30.0 | -0.170 | 0.066 | -0.300 | -0.039 |
| Hazard Ratio | 1.00 | 31.00 | 30.0 | 0.850 | 0.740 | 0.960 | |
| Age at delivery | 27.00 | 31.00 | 4.0 | -0.120 | 0.084 | -0.280 | 0.049 |
| Hazard Ratio | 27.00 | 31.00 | 4.0 | 0.890 | 0.760 | 1.000 | |
| Number of Gestation weeks | 37.00 | 39.00 | 2.0 | -0.094 | 0.072 | -0.230 | 0.048 |
| Hazard Ratio | 37.00 | 39.00 | 2.0 | 0.910 | 0.790 | 1.000 | |
| CDC SVI overall percentile ranking of all 4 themes | 0.25 | 0.75 | 0.5 | -0.240 | 0.190 | -0.620 | 0.140 |
| Hazard Ratio | 0.25 | 0.75 | 0.5 | 0.790 | 0.540 | 1.100 | |
| Number of previous pregnancies | 1.00 | 3.00 | 2.0 | 0.034 | 0.097 | -0.160 | 0.220 |
| Hazard Ratio | 1.00 | 3.00 | 2.0 | 1.000 | 0.860 | 1.300 | |
| Race/Ethnicity binary --- All Other:Non---Hispanic White | 2.00 | 1.00 | 0.700 | 0.310 | 0.093 | 1.300 | |
| Hazard Ratio | 2.00 | 1.00 | 2.000 | 1.100 | 3.700 | ||
| Route of delivery --- Cesarean:Vaginal | 2.00 | 1.00 | 0.014 | 0.200 | -0.380 | 0.410 | |
| Hazard Ratio | 2.00 | 1.00 | 1.000 | 0.690 | 1.500 | ||
| Combined pain --- Yes:No | 1.00 | 2.00 | -0.340 | 0.200 | -0.740 | 0.056 | |
| Hazard Ratio | 1.00 | 2.00 | 0.710 | 0.480 | 1.100 | ||
| Schizophrenia or personality disorder --- Yes:No | 1.00 | 2.00 | 0.340 | 0.260 | -0.180 | 0.860 | |
| Hazard Ratio | 1.00 | 2.00 | 1.400 | 0.840 | 2.400 | ||
| Alcohol or other substance use --- Yes:No | 1.00 | 2.00 | 0.260 | 0.200 | -0.130 | 0.640 | |
| Hazard Ratio | 1.00 | 2.00 | 1.300 | 0.880 | 1.900 | ||
| Benzodiazepine or anticonvulsant use --- Yes:No | 1.00 | 2.00 | 0.170 | 0.240 | -0.310 | 0.640 | |
| Hazard Ratio | 1.00 | 2.00 | 1.200 | 0.730 | 1.900 | ||
| Anxiety --- Yes:No | 1.00 | 2.00 | 0.260 | 0.210 | -0.150 | 0.660 | |
| Hazard Ratio | 1.00 | 2.00 | 1.300 | 0.860 | 1.900 | ||
| Depression --- Yes:No | 1.00 | 2.00 | 0.570 | 0.200 | 0.180 | 0.960 | |
| Hazard Ratio | 1.00 | 2.00 | 1.800 | 1.200 | 2.600 | ||
| Maternal morbidity --- Yes:No | 1.00 | 2.00 | -0.075 | 0.400 | -0.860 | 0.710 | |
| Hazard Ratio | 1.00 | 2.00 | 0.930 | 0.420 | 2.000 | ||
Wald Statistics for Surv(days.to.event, outcome.bin) | |||
| χ2 | d.f. | P | |
|---|---|---|---|
| Year of delivery | 13.56 | 1 | 0.0002 |
| Total days supplied MOUD (method 3) | 6.47 | 1 | 0.0110 |
| Age at delivery | 1.91 | 1 | 0.1670 |
| Race/Ethnicity binary | 5.12 | 1 | 0.0236 |
| Route of delivery | 0.01 | 1 | 0.9426 |
| Number of Gestation weeks | 1.68 | 1 | 0.1945 |
| Combined pain | 2.84 | 1 | 0.0918 |
| Schizophrenia or personality disorder | 1.67 | 1 | 0.1966 |
| Alcohol or other substance use | 1.74 | 1 | 0.1875 |
| Benzodiazepine or anticonvulsant use | 0.47 | 1 | 0.4942 |
| Anxiety | 1.57 | 1 | 0.2105 |
| Depression | 8.33 | 1 | 0.0039 |
| Maternal morbidity | 0.04 | 1 | 0.8506 |
| CDC SVI overall percentile ranking of all 4 themes | 1.58 | 1 | 0.2092 |
| Number of previous pregnancies | 0.12 | 1 | 0.7252 |
| TOTAL | 80.25 | 15 | <0.0001 |
3.3.2 With splines
Effects Response: Surv(days.to.event, outcome.bin) | |||||||
| Low | High | Δ | Effect | S.E. | Lower 0.95 | Upper 0.95 | |
|---|---|---|---|---|---|---|---|
| Year of delivery | 2016.00 | 2018.00 | 2.0 | 0.47090 | 0.11120 | 0.25290 | 0.68880 |
| Hazard Ratio | 2016.00 | 2018.00 | 2.0 | 1.60100 | 1.28800 | 1.99100 | |
| Total days supplied MOUD (method 3) | 1.00 | 31.00 | 30.0 | 0.01435 | 0.17160 | -0.32200 | 0.35070 |
| Hazard Ratio | 1.00 | 31.00 | 30.0 | 1.01400 | 0.72470 | 1.42000 | |
| Age at delivery | 27.00 | 31.00 | 4.0 | -0.11630 | 0.08410 | -0.28120 | 0.04851 |
| Hazard Ratio | 27.00 | 31.00 | 4.0 | 0.89020 | 0.75490 | 1.05000 | |
| Number of Gestation weeks | 39.00 | 37.00 | -2.0 | 0.09535 | 0.07286 | -0.04745 | 0.23810 |
| Hazard Ratio | 39.00 | 37.00 | -2.0 | 1.10000 | 0.95370 | 1.26900 | |
| CDC SVI overall percentile ranking of all 4 themes | 0.25 | 0.75 | 0.5 | -0.23650 | 0.19350 | -0.61580 | 0.14280 |
| Hazard Ratio | 0.25 | 0.75 | 0.5 | 0.78940 | 0.54020 | 1.15400 | |
| Number of previous pregnancies | 1.00 | 3.00 | 2.0 | 0.03295 | 0.09814 | -0.15940 | 0.22530 |
| Hazard Ratio | 1.00 | 3.00 | 2.0 | 1.03300 | 0.85270 | 1.25300 | |
| Race/Ethnicity binary --- All Other:Non---Hispanic White | 2.00 | 1.00 | 0.68920 | 0.31030 | 0.08100 | 1.29700 | |
| Hazard Ratio | 2.00 | 1.00 | 1.99200 | 1.08400 | 3.66000 | ||
| Route of delivery --- Cesarean:Vaginal | 2.00 | 1.00 | 0.02069 | 0.20030 | -0.37190 | 0.41330 | |
| Hazard Ratio | 2.00 | 1.00 | 1.02100 | 0.68940 | 1.51200 | ||
| Combined pain --- Yes:No | 1.00 | 2.00 | -0.35180 | 0.20420 | -0.75190 | 0.04833 | |
| Hazard Ratio | 1.00 | 2.00 | 0.70340 | 0.47150 | 1.05000 | ||
| Schizophrenia or personality disorder --- Yes:No | 1.00 | 2.00 | 0.31730 | 0.26290 | -0.19800 | 0.83250 | |
| Hazard Ratio | 1.00 | 2.00 | 1.37300 | 0.82040 | 2.29900 | ||
| Alcohol or other substance use --- Yes:No | 1.00 | 2.00 | 0.25230 | 0.19610 | -0.13190 | 0.63660 | |
| Hazard Ratio | 1.00 | 2.00 | 1.28700 | 0.87640 | 1.89000 | ||
| Benzodiazepine or anticonvulsant use --- Yes:No | 1.00 | 2.00 | 0.18050 | 0.24620 | -0.30210 | 0.66320 | |
| Hazard Ratio | 1.00 | 2.00 | 1.19800 | 0.73930 | 1.94100 | ||
| Anxiety --- Yes:No | 1.00 | 2.00 | 0.26620 | 0.20840 | -0.14220 | 0.67460 | |
| Hazard Ratio | 1.00 | 2.00 | 1.30500 | 0.86740 | 1.96300 | ||
| Depression --- Yes:No | 1.00 | 2.00 | 0.56730 | 0.19880 | 0.17780 | 0.95690 | |
| Hazard Ratio | 1.00 | 2.00 | 1.76400 | 1.19500 | 2.60400 | ||
| Maternal morbidity --- Yes:No | 1.00 | 2.00 | -0.08026 | 0.39990 | -0.86400 | 0.70350 | |
| Hazard Ratio | 1.00 | 2.00 | 0.92290 | 0.42150 | 2.02100 | ||
Wald Statistics for Surv(days.to.event, outcome.bin) | |||
| χ2 | d.f. | P | |
|---|---|---|---|
| Year of delivery | 20.30 | 2 | <0.0001 |
| Nonlinear | 1.58 | 1 | 0.2082 |
| Total days supplied MOUD (method 3) | 6.82 | 2 | 0.0331 |
| Nonlinear | 1.34 | 1 | 0.2472 |
| Age at delivery | 1.92 | 1 | 0.1663 |
| Race/Ethnicity binary | 4.94 | 1 | 0.0262 |
| Route of delivery | 0.01 | 1 | 0.9177 |
| Number of Gestation weeks | 1.72 | 1 | 0.1902 |
| Combined pain | 2.97 | 1 | 0.0849 |
| Schizophrenia or personality disorder | 1.46 | 1 | 0.2269 |
| Alcohol or other substance use | 1.66 | 1 | 0.1979 |
| Benzodiazepine or anticonvulsant use | 0.54 | 1 | 0.4634 |
| Anxiety | 1.63 | 1 | 0.2013 |
| Depression | 8.15 | 1 | 0.0043 |
| Maternal morbidity | 0.04 | 1 | 0.8408 |
| CDC SVI overall percentile ranking of all 4 themes | 1.49 | 1 | 0.2215 |
| Number of previous pregnancies | 0.11 | 1 | 0.7368 |
| TOTAL NONLINEAR | 3.02 | 2 | 0.2207 |
| TOTAL | 90.75 | 17 | <0.0001 |
4 Propensity Score (Matching Weights) by MOUD receipt
- Mirror histograms show propensity scores of the control group above the horizontal line in white, while the treatment group is below the horizontal line in dark green. Light green bars display the summation of weights of subjects within each propensity score stratum. This plot shows good overlap between the control and treatment groups, and the close similarity between them after applying matching weights.
4.1 Absolute standardized mean difference plot
4.2 Logistic regression model
Call:
glm(formula = outcome.bin ~ moud.yes, family = binomial(link = "logit"),
data = basic, weights = mw$W)
Coefficients:
Estimate Std. Error z value Pr(>|z|)
(Intercept) -3.9566 0.1009 -39.221 <0.0000000000000002 ***
moud.yes -0.2424 0.1508 -1.608 0.108
---
Signif. codes: 0 '***' 0.001 '**' 0.01 '*' 0.05 '.' 0.1 ' ' 1
(Dispersion parameter for binomial family taken to be 1)
Null deviance: 1838.6 on 15102 degrees of freedom
Residual deviance: 1836.0 on 15101 degrees of freedom
AIC: 1772.4
Number of Fisher Scoring iterations: 7- exponentiated Odds Ratio
OR 2.5 % 97.5 %
(Intercept) 0.01912766 0.01559458 0.02316825
moud.yes 0.78472227 0.58274573 1.053513625 Only including data of women with MOUD receipt
5.1 Descriptive Statistics
- There are 7472 pregnancies in 6387 unique individuals
N Overall (N=7472) Year of delivery 7472 (100.00) Median (interquartile range) 2016 (2014—2018) Range 2007—2020 Age at delivery 7472 (100.00) Median (interquartile range) 27 (24—31) Range 17—44 Number of Gestation weeks 7472 (100.00) Median (interquartile range) 39 (37—39) Range 21—42 Race 7472 (100.00) American Indian or Alaska Native 23/7472 (0.31) Asian or Pacific Islander 11/7472 (0.15) Black of African American 210/7472 (2.81) Other or Unknown 53/7472 (0.71) White 7175/7472 (96.03) Hispanic : Not Hispanic 7465 (99.91) 7398/7465 (99.10) Race/Ethnicity combined 7472 (100.00) Hispanic 67/7472 (0.90) Non-Hispanic Asian 11/7472 (0.15) Non-Hispanic Black 209/7472 (2.80) Non-Hispanic Other 55/7472 (0.74) Non-Hispanic White 7130/7472 (95.42) Route of delivery : Vaginal 7472 (100.00) 4857/7472 (65.00) Number of previous pregnancies 7335 (98.17) Median (interquartile range) 2 (1—3) Range 0—23 Final outcome 7472 (100.00) Death 30/7472 (0.40) Overdose 97/7472 (1.30) Loss of enrollment 709/7472 (9.49) Censored 6636/7472 (88.81) Final outcome (w/o all payer data) 7472 (100.00) Death 11/7472 (0.15) Overdose 91/7472 (1.22) Loss of enrollment 734/7472 (9.82) Censored 6636/7472 (88.81) Total days supplied MOUD 7472 (100.00) Median (interquartile range) 96 (56—120) Range 1—132 Total days supplied MOUD before delivery 7472 (100.00) Median (interquartile range) 74 (35—90) Range 0—90 Total days supplied MOUD after delivery 7472 (100.00) Median (interquartile range) 30 (9—42) Range 0—42 Total days supplied MOUD (method 2) 7472 (100.00) Median (interquartile range) 98 (56—125) Range 1—132 Total days supplied MOUD before delivery (method 2) 7472 (100.00) Median (interquartile range) 74 (35—90) Range 0—90 Total days supplied MOUD after delivery (method 2) 7472 (100.00) Median (interquartile range) 30 (14—42) Range 0—42 Total days supplied MOUD (method 3) 7472 (100.00) Median (interquartile range) 89 (47—112) Range 1—132 Total days supplied MOUD before delivery (method 3) 7472 (100.00) Median (interquartile range) 62 (30—78) Range 0—90 Total days supplied MOUD after delivery (method 3) 7472 (100.00) Median (interquartile range) 30 (13—40) Range 0—42 Avg dose pre-delivery (mg) 7394 (98.96) Median (interquartile range) 14.24 (8.00—16.00) Range 0.00—50.00 Avg dose post-delivery (mg) 7394 (98.96) Median (interquartile range) 9.72 (4.00—16.00) Range 0.00—53.57 Avg dose exposure (mg) 7394 (98.96) Median (interquartile range) 14.09 (9.42—16.00) Range 0.14—53.57 Total days buprenorphine before delivery (method 3) 7299 (97.68) Median (interquartile range) 63.00 (30.00—78.00) Range 0.00—90.00 Total days buprenorphine after delivery (method 3) 7299 (97.68) Median (interquartile range) 30.00 (13.00—41.00) Range 0.00—42.00 Total days supplied buprenorphine 7299 (97.68) Median (interquartile range) 90.00 (49.00—112.00) Range 1.00—132.00 Avg dose BUP pre-delivery (mg) 7298 (97.67) Median (interquartile range) 14.12 (8.00—16.00) Range 0.00—35.42 Avg dose BUP post-delivery (mg) 7298 (97.67) Median (interquartile range) 9.71 (4.00—16.00) Range 0.00—42.67 Avg dose BUP exposure (mg) 7298 (97.67) Median (interquartile range) 13.98 (9.13—16.00) Range 0.14—42.67 Combined pain : Yes 7472 (100.00) 5766/7472 (77.17) Schizophrenia or personality disorder : Yes 7472 (100.00) 583/7472 (7.80) Alcohol or other substance use : Yes 7472 (100.00) 3342/7472 (44.73) Benzodiazepine or anticonvulsant use : Yes 7472 (100.00) 1077/7472 (14.41) Maternal morbidity : Yes 7472 (100.00) 528/7472 (7.07) Anxiety and depression combined : Yes 7472 (100.00) 3485/7472 (46.64) Back pain : Yes 7472 (100.00) 2528/7472 (33.83) Depression : Yes 7472 (100.00) 2946/7472 (39.43) Bipolar disorder : Yes 7472 (100.00) 819/7472 (10.96) Other substance use : Yes 7472 (100.00) 3197/7472 (42.79) Tobacco use : Yes 7472 (100.00) 5196/7472 (69.54) Med NSAIDS : Yes 7472 (100.00) 4602/7472 (61.59) Schizophrenia psychotic disorders : Yes 7472 (100.00) 466/7472 (6.24) Anxiety : Yes 7472 (100.00) 1608/7472 (21.52) Med benzodiazepine use : Yes 7472 (100.00) 713/7472 (9.54) Maternal morbidity : Yes 7472 (100.00) 528/7472 (7.07) Dental pain : Yes 7472 (100.00) 298/7472 (3.99) Alcohol use disorder : Yes 7472 (100.00) 507/7472 (6.79) Med anticonvulsant use : Yes 7472 (100.00) 432/7472 (5.78) Med muscle relaxant use : Yes 7472 (100.00) 371/7472 (4.97) Personality disorder : Yes 7472 (100.00) 220/7472 (2.94) Fibromyalgia : Yes 7472 (100.00) 383/7472 (5.13) CDC SVI overall percentile ranking of all 4 themes 7042 (94.25) Median (interquartile range) 0.58 (0.37—0.79) Range 0.00—1.00 N is the number of non-missing value. 1Kruskal-Wallis. 2Pearson. 3Wilcoxon.
5.2 By cases
| N | No outcome | Had outcome | Test Statistic | |
|---|---|---|---|---|
| (N=7345) | (N=127) | |||
| Year of delivery | 7472 (100.00) | F1,7470=36.05, P<0.00013 | ||
| Median (interquartile range) | 2016 (2014—2018) | 2018 (2016—2019) | ||
| Range | 2007—2020 | 2007—2020 | ||
| Age at delivery | 7472 (100.00) | F1,7470=0.04, P=0.83303 | ||
| Median (interquartile range) | 27 (24—31) | 27 (25—31) | ||
| Range | 17—44 | 19—41 | ||
| Number of Gestation weeks | 7472 (100.00) | F1,7470=3.29, P=0.06983 | ||
| Median (interquartile range) | 39 (37—39) | 38 (37—39) | ||
| Range | 21—42 | 25—42 | ||
| Race | 7472 (100.00) |
Χ2 4=31.51, P<0.00012 |
||
| American Indian or Alaska Native | 22/7345 (0.30) | 1/127 (0.79) | ||
| Asian or Pacific Islander | 11/7345 (0.15) | 0/127 (0.00) | ||
| Black of African American | 205/7345 (2.79) | 5/127 (3.94) | ||
| Other or Unknown | 47/7345 (0.64) | 6/127 (4.72) | ||
| White | 7060/7345 (96.12) | 115/127 (90.55) | ||
| Hispanic : Not Hispanic | 7465 (99.91) | 7273/7338 (99.11) | 125/127 (98.43) |
Χ2 1=0.67, P=0.41432 |
| Race/Ethnicity combined | 7472 (100.00) |
Χ2 4=29.81, P<0.00012 |
||
| Hispanic | 65/7345 (0.88) | 2/127 (1.57) | ||
| Non-Hispanic Asian | 11/7345 (0.15) | 0/127 (0.00) | ||
| Non-Hispanic Black | 204/7345 (2.78) | 5/127 (3.94) | ||
| Non-Hispanic Other | 49/7345 (0.67) | 6/127 (4.72) | ||
| Non-Hispanic White | 7016/7345 (95.52) | 114/127 (89.76) | ||
| Route of delivery : Vaginal | 7472 (100.00) | 4774/7345 (65.00) | 83/127 (65.35) |
Χ2 1=0.01, P=0.93322 |
| Number of previous pregnancies | 7335 (98.17) | F1,7333=0.97, P=0.32553 | ||
| Median (interquartile range) | 2 (1—3) | 2 (1—3) | ||
| Range | 0—23 | 0—11 | ||
| Final outcome | 7472 (100.00) |
Χ2 3=7472.00, P<0.00012 |
||
| Death | 0/7345 (0.00) | 30/127 (23.62) | ||
| Overdose | 0/7345 (0.00) | 97/127 (76.38) | ||
| Loss of enrollment | 709/7345 (9.65) | 0/127 (0.00) | ||
| Censored | 6636/7345 (90.35) | 0/127 (0.00) | ||
| Final outcome (w/o all payer data) | 7472 (100.00) |
Χ2 3=6026.67, P<0.00012 |
||
| Death | 0/7345 (0.00) | 11/127 (8.66) | ||
| Overdose | 0/7345 (0.00) | 91/127 (71.65) | ||
| Loss of enrollment | 709/7345 (9.65) | 25/127 (19.69) | ||
| Censored | 6636/7345 (90.35) | 0/127 (0.00) | ||
| Total days supplied MOUD (method 3) | 7472 (100.00) | F1,7470=11.45, P=0.00073 | ||
| Median (interquartile range) | 89 (47—112) | 73 (30—104) | ||
| Range | 1—132 | 2—131 | ||
| Total days supplied MOUD before delivery (method 3) | 7472 (100.00) | F1,7470=4.92, P=0.02653 | ||
| Median (interquartile range) | 62 (30—78) | 53 (17—77) | ||
| Range | 0—90 | 0—89 | ||
| Total days supplied MOUD after delivery (method 3) | 7472 (100.00) | F1,7470=15.99, P=0.00013 | ||
| Median (interquartile range) | 30 (13—41) | 21 (5—35) | ||
| Range | 0—42 | 0—42 | ||
| Avg dose pre-delivery (mg) | 7394 (98.96) | F1,7392=0.18, P=0.67513 | ||
| Median (interquartile range) | 14.25 (8.00—16.00) | 13.20 (8.00—16.00) | ||
| Range | 0.00—50.00 | 0.00—50.00 | ||
| Avg dose post-delivery (mg) | 7394 (98.96) | F1,7392=0.98, P=0.32173 | ||
| Median (interquartile range) | 9.76 (4.00—16.00) | 8.94 (0.00—16.00) | ||
| Range | 0.00—53.57 | 0.00—24.00 | ||
| Avg dose exposure (mg) | 7394 (98.96) | F1,7392=0.51, P=0.47583 | ||
| Median (interquartile range) | 14.09 (9.43—16.00) | 13.96 (8.74—16.00) | ||
| Range | 0.14—53.57 | 1.00—50.00 | ||
| Total days buprenorphine before delivery (method 3) | 7299 (97.68) | F1,7297=7.19, P=0.00743 | ||
| Median (interquartile range) | 63.00 (30.00—78.00) | 49.00 (16.00—76.33) | ||
| Range | 0.00—90.00 | 0.00—89.00 | ||
| Total days buprenorphine after delivery (method 3) | 7299 (97.68) | F1,7297=21.00, P<0.00013 | ||
| Median (interquartile range) | 30.00 (13.00—41.00) | 18.00 (3.33—34.33) | ||
| Range | 0.00—42.00 | 0.00—42.00 | ||
| Total days supplied buprenorphine | 7299 (97.68) | F1,7297=15.41, P=0.00013 | ||
| Median (interquartile range) | 90.00 (49.00—112.00) | 71.00 (28.00—103.33) | ||
| Range | 1.00—132.00 | 2.00—131.00 | ||
| Avg dose BUP pre-delivery (mg) | 7298 (97.67) | F1,7296=0.80, P=0.36993 | ||
| Median (interquartile range) | 14.13 (8.00—16.00) | 12.66 (8.00—16.00) | ||
| Range | 0.00—35.42 | 0.00—24.24 | ||
| Avg dose BUP post-delivery (mg) | 7298 (97.67) | F1,7296=0.49, P=0.48323 | ||
| Median (interquartile range) | 9.71 (4.00—16.00) | 9.13 (0.00—16.00) | ||
| Range | 0.00—42.67 | 0.00—24.00 | ||
| Avg dose BUP exposure (mg) | 7298 (97.67) | F1,7296=0.16, P=0.68873 | ||
| Median (interquartile range) | 13.98 (9.14—16.00) | 13.40 (8.67—16.00) | ||
| Range | 0.14—42.67 | 1.00—24.20 | ||
| Combined pain : Yes | 7472 (100.00) | 5677/7345 (77.29) | 89/127 (70.08) |
Χ2 1=3.69, P=0.05492 |
| Schizophrenia or personality disorder : Yes | 7472 (100.00) | 564/7345 (7.68) | 19/127 (14.96) |
Χ2 1=9.20, P=0.00242 |
| Alcohol or other substance use : Yes | 7472 (100.00) | 3275/7345 (44.59) | 67/127 (52.76) |
Χ2 1=3.37, P=0.06642 |
| Benzodiazepine or anticonvulsant use : Yes | 7472 (100.00) | 1052/7345 (14.32) | 25/127 (19.69) |
Χ2 1=2.91, P=0.08802 |
| Maternal morbidity : Yes | 7472 (100.00) | 519/7345 (7.07) | 9/127 (7.09) |
Χ2 1=0.00, P=0.99282 |
| Anxiety and depression combined : Yes | 7472 (100.00) | 3400/7345 (46.29) | 85/127 (66.93) |
Χ2 1=21.37, P<0.00012 |
| Back pain : Yes | 7472 (100.00) | 2496/7345 (33.98) | 32/127 (25.20) |
Χ2 1=4.30, P=0.03802 |
| Depression : Yes | 7472 (100.00) | 2868/7345 (39.05) | 78/127 (61.42) |
Χ2 1=26.16, P<0.00012 |
| Bipolar disorder : Yes | 7472 (100.00) | 790/7345 (10.76) | 29/127 (22.83) |
Χ2 1=18.66, P<0.00012 |
| Other substance use : Yes | 7472 (100.00) | 3130/7345 (42.61) | 67/127 (52.76) |
Χ2 1=5.25, P=0.02202 |
| Tobacco use : Yes | 7472 (100.00) | 5101/7345 (69.45) | 95/127 (74.80) |
Χ2 1=1.69, P=0.19362 |
| Med NSAIDS : Yes | 7472 (100.00) | 4530/7345 (61.67) | 72/127 (56.69) |
Χ2 1=1.31, P=0.25252 |
| Schizophrenia psychotic disorders : Yes | 7472 (100.00) | 448/7345 (6.10) | 18/127 (14.17) |
Χ2 1=13.92, P=0.00022 |
| Anxiety : Yes | 7472 (100.00) | 1562/7345 (21.27) | 46/127 (36.22) |
Χ2 1=16.53, P<0.00012 |
| Med benzodiazepine use : Yes | 7472 (100.00) | 701/7345 (9.54) | 12/127 (9.45) |
Χ2 1=0.00, P=0.97122 |
| Maternal morbidity : Yes | 7472 (100.00) | 519/7345 (7.07) | 9/127 (7.09) |
Χ2 1=0.00, P=0.99282 |
| Dental pain : Yes | 7472 (100.00) | 291/7345 (3.96) | 7/127 (5.51) |
Χ2 1=0.78, P=0.37622 |
| Alcohol use disorder : Yes | 7472 (100.00) | 485/7345 (6.60) | 22/127 (17.32) |
Χ2 1=22.68, P<0.00012 |
| Med anticonvulsant use : Yes | 7472 (100.00) | 416/7345 (5.66) | 16/127 (12.60) |
Χ2 1=11.02, P=0.00092 |
| Med muscle relaxant use : Yes | 7472 (100.00) | 363/7345 (4.94) | 8/127 (6.30) |
Χ2 1=0.49, P=0.48522 |
| Personality disorder : Yes | 7472 (100.00) | 214/7345 (2.91) | 6/127 (4.72) |
Χ2 1=1.43, P=0.23132 |
| Fibromyalgia : Yes | 7472 (100.00) | 376/7345 (5.12) | 7/127 (5.51) |
Χ2 1=0.04, P=0.84232 |
| CDC SVI overall percentile ranking of all 4 themes | 7042 (94.25) | F1,7040=0.80, P=0.37143 | ||
| Median (interquartile range) | 0.58 (0.37—0.79) | 0.54 (0.31—0.83) | ||
| Range | 0.00—1.00 | 0.00—1.00 |
N is the number of non-missing value. 1Kruskal-Wallis.
2Pearson. 3Wilcoxon.
5.3 MOUD information
| N | All | |
|---|---|---|
| (N=7472) | ||
| MOUD pre-delivery (method 1) | 7472 (100.00) | |
| No MOUD | 634/7472 (8.49) | |
| MOUD | 6838/7472 (91.51) | |
| MOUD pre-delivery (method 2) | 7472 (100.00) | |
| No MOUD | 634/7472 (8.49) | |
| MOUD | 6838/7472 (91.51) | |
| MOUD pre-delivery (method 3) | 7472 (100.00) | |
| No MOUD | 638/7472 (8.54) | |
| MOUD | 6834/7472 (91.46) | |
| MOUD post-delivery (method 1) | 7472 (100.00) | |
| No MOUD | 1494/7472 (19.99) | |
| MOUD | 5978/7472 (80.01) | |
| MOUD post-delivery (method 2) | 7472 (100.00) | |
| No MOUD | 1300/7472 (17.40) | |
| MOUD | 6172/7472 (82.60) | |
| MOUD post-delivery (method 3) | 7472 (100.00) | |
| No MOUD | 898/7472 (12.02) | |
| MOUD | 6574/7472 (87.98) | |
| MOUD pre and post (method 1) | 7472 (100.00) | |
| No MOUD | 0/7472 (0.00) | |
| Both pre and post | 5344/7472 (71.52) | |
| Either pre or post | 2128/7472 (28.48) | |
| MOUD pre and post (method 2) | 7472 (100.00) | |
| No MOUD | 0/7472 (0.00) | |
| Both pre and post | 5538/7472 (74.12) | |
| Either pre or post | 1934/7472 (25.88) | |
| MOUD pre and post (method 3) | 7472 (100.00) | |
| No MOUD | 0/7472 (0.00) | |
| Both pre and post | 5936/7472 (79.44) | |
| Either pre or post | 1536/7472 (20.56) |
N is the number of non-missing value. 1Kruskal-Wallis.
2Pearson. 3Wilcoxon.
5.4 Characteristics based on MOUD timing (method 3)
5.4.1 Two categories
| N | Both pre and post | Either pre or post | Test Statistic | |
|---|---|---|---|---|
| (N=5936) | (N=1536) | |||
| Year of delivery | 7472 (100.00) | F1,7470=6.08, P=0.01373 | ||
| Median (interquartile range) | 2016 (2014—2018) | 2016 (2014—2018) | ||
| Range | 2007—2020 | 2007—2020 | ||
| Year of delivery as categorical | 7472 (100.00) |
Χ2 13=53.65, P<0.00012 |
||
| 2007 | 25/5936 (0.42) | 7/1536 (0.46) | ||
| 2008 | 41/5936 (0.69) | 18/1536 (1.17) | ||
| 2009 | 52/5936 (0.88) | 29/1536 (1.89) | ||
| 2010 | 112/5936 (1.89) | 30/1536 (1.95) | ||
| 2011 | 146/5936 (2.46) | 46/1536 (2.99) | ||
| 2012 | 223/5936 (3.76) | 47/1536 (3.06) | ||
| 2013 | 438/5936 (7.38) | 83/1536 (5.40) | ||
| 2014 | 684/5936 (11.52) | 127/1536 (8.27) | ||
| 2015 | 821/5936 (13.83) | 181/1536 (11.78) | ||
| 2016 | 769/5936 (12.95) | 216/1536 (14.06) | ||
| 2017 | 635/5936 (10.70) | 194/1536 (12.63) | ||
| 2018 | 621/5936 (10.46) | 183/1536 (11.91) | ||
| 2019 | 663/5936 (11.17) | 204/1536 (13.28) | ||
| 2020 | 706/5936 (11.89) | 171/1536 (11.13) | ||
| Age at delivery | 7472 (100.00) | F1,7470=0.46, P=0.49643 | ||
| Median (interquartile range) | 27 (24—31) | 27 (24—31) | ||
| Range | 17—44 | 17—44 | ||
| Number of Gestation weeks | 7472 (100.00) | F1,7470=20.74, P<0.00013 | ||
| Median (interquartile range) | 39 (37—39) | 38 (37—39) | ||
| Range | 21—42 | 23—42 | ||
| Race | 7472 (100.00) |
Χ2 4=10.38, P=0.03462 |
||
| American Indian or Alaska Native | 16/5936 (0.27) | 7/1536 (0.46) | ||
| Asian or Pacific Islander | 9/5936 (0.15) | 2/1536 (0.13) | ||
| Black of African American | 153/5936 (2.58) | 57/1536 (3.71) | ||
| Other or Unknown | 37/5936 (0.62) | 16/1536 (1.04) | ||
| White | 5721/5936 (96.38) | 1454/1536 (94.66) | ||
| Hispanic : Not Hispanic | 7465 (99.91) | 5879/5933 (99.09) | 1519/1532 (99.15) |
Χ2 1=0.05, P=0.81972 |
| Race/Ethnicity combined | 7472 (100.00) |
Χ2 4=13.85, P=0.00782 |
||
| Hispanic | 54/5936 (0.91) | 13/1536 (0.85) | ||
| Non-Hispanic Asian | 9/5936 (0.15) | 2/1536 (0.13) | ||
| Non-Hispanic Black | 153/5936 (2.58) | 56/1536 (3.65) | ||
| Non-Hispanic Other | 35/5936 (0.59) | 20/1536 (1.30) | ||
| Non-Hispanic White | 5685/5936 (95.77) | 1445/1536 (94.08) | ||
| Route of delivery : Vaginal | 7472 (100.00) | 3822/5936 (64.39) | 1035/1536 (67.38) |
Χ2 1=4.81, P=0.02822 |
| Number of previous pregnancies | 7335 (98.17) | F1,7333=4.07, P=0.04383 | ||
| Median (interquartile range) | 2 (1—3) | 2 (1—3) | ||
| Range | 0—23 | 0—23 | ||
| Final outcome | 7472 (100.00) |
Χ2 3=34.63, P<0.00012 |
||
| Death | 25/5936 (0.42) | 5/1536 (0.33) | ||
| Overdose | 62/5936 (1.04) | 35/1536 (2.28) | ||
| Loss of enrollment | 519/5936 (8.74) | 190/1536 (12.37) | ||
| Censored | 5330/5936 (89.79) | 1306/1536 (85.03) | ||
| Final outcome 3 levels | 7472 (100.00) |
Χ2 2=14.76, P=0.00062 |
||
| Death | 25/5936 (0.42) | 5/1536 (0.33) | ||
| Overdose | 62/5936 (1.04) | 35/1536 (2.28) | ||
| Censored | 5849/5936 (98.53) | 1496/1536 (97.40) | ||
| Total days supplied MOUD | 7472 (100.00) | F1,7470=5071.00, P<0.00013 | ||
| Median (interquartile range) | 108 (84—122) | 29 (14—42) | ||
| Range | 7—132 | 1—90 | ||
| Total days supplied MOUD before delivery | 7472 (100.00) | F1,7470=3779.50, P<0.00013 | ||
| Median (interquartile range) | 84 (60—90) | 11 (0—35) | ||
| Range | 1—90 | 0—90 | ||
| Total days supplied MOUD after delivery | 7472 (100.00) | F1,7470=1748.75, P<0.00013 | ||
| Median (interquartile range) | 30 (21—42) | 0 (0—21) | ||
| Range | 0—42 | 0—42 | ||
| Total days supplied MOUD (method 2) | 7472 (100.00) | F1,7470=4954.77, P<0.00013 | ||
| Median (interquartile range) | 112 (84—129) | 29 (14—42) | ||
| Range | 7—132 | 1—132 | ||
| Total days supplied MOUD before delivery (method 2) | 7472 (100.00) | F1,7470=3779.50, P<0.00013 | ||
| Median (interquartile range) | 84 (60—90) | 11 (0—35) | ||
| Range | 1—90 | 0—90 | ||
| Total days supplied MOUD after delivery (method 2) | 7472 (100.00) | F1,7470=2132.86, P<0.00013 | ||
| Median (interquartile range) | 35 (24—42) | 0 (0—23) | ||
| Range | 0—42 | 0—42 | ||
| Total days supplied MOUD (method 3) | 7472 (100.00) | F1,7470=5107.13, P<0.00013 | ||
| Median (interquartile range) | 100 (76—116) | 22 (11—34) | ||
| Range | 7—132 | 1—89 | ||
| Total days supplied MOUD before delivery (method 3) | 7472 (100.00) | F1,7470=3154.36, P<0.00013 | ||
| Median (interquartile range) | 69 (48—80) | 10 (0—32) | ||
| Range | 1—90 | 0—89 | ||
| Total days supplied MOUD after delivery (method 3) | 7472 (100.00) | F1,7470=4221.19, P<0.00013 | ||
| Median (interquartile range) | 35 (23—41) | 0 (0—11) | ||
| Range | 1—42 | 0—41 | ||
| Avg dose pre-delivery (mg) | 7394 (98.96) | F1,7392=750.98, P<0.00013 | ||
| Median (interquartile range) | 15.00 (9.94—16.00) | 7.37 (0.00—16.00) | ||
| Range | 0.25—50.00 | 0.00—50.00 | ||
| Avg dose post-delivery (mg) | 7394 (98.96) | F1,7392=858.54, P<0.00013 | ||
| Median (interquartile range) | 12.00 (8.00—16.00) | 0.00 (0.00—10.76) | ||
| Range | 0.00—50.00 | 0.00—53.57 | ||
| Avg dose exposure (mg) | 7394 (98.96) | F1,7392=1.73, P=0.18813 | ||
| Median (interquartile range) | 14.04 (9.87—16.00) | 14.55 (8.00—16.00) | ||
| Range | 0.25—50.00 | 0.14—53.57 | ||
| Total days buprenorphine before delivery (method 3) | 7299 (97.68) | F1,7297=2768.33, P<0.00013 | ||
| Median (interquartile range) | 69.00 (48.00—80.00) | 14.00 (0.00—33.00) | ||
| Range | 0.00—90.00 | 0.00—89.00 | ||
| Total days buprenorphine after delivery (method 3) | 7299 (97.68) | F1,7297=3874.92, P<0.00013 | ||
| Median (interquartile range) | 35.00 (23.00—41.00) | 0.00 (0.00—9.00) | ||
| Range | 0.00—42.00 | 0.00—41.00 | ||
| Total days supplied buprenorphine | 7299 (97.68) | F1,7297=4518.19, P<0.00013 | ||
| Median (interquartile range) | 100.00 (76.00—116.00) | 22.00 (11.17—35.00) | ||
| Range | 4.00—132.00 | 1.00—89.00 | ||
| Avg dose BUP pre-delivery (mg) | 7298 (97.67) | F1,7296=753.31, P<0.00013 | ||
| Median (interquartile range) | 14.86 (9.67—16.00) | 7.47 (0.00—15.71) | ||
| Range | 0.00—35.42 | 0.00—29.71 | ||
| Avg dose BUP post-delivery (mg) | 7298 (97.67) | F1,7296=927.21, P<0.00013 | ||
| Median (interquartile range) | 12.00 (8.00—16.00) | 0.00 (0.00—9.63) | ||
| Range | 0.00—33.24 | 0.00—42.67 | ||
| Avg dose BUP exposure (mg) | 7298 (97.67) | F1,7296=0.00, P=0.99873 | ||
| Median (interquartile range) | 13.98 (9.75—16.00) | 14.00 (8.00—16.00) | ||
| Range | 0.25—34.47 | 0.14—42.67 | ||
| Combined pain : Yes | 7472 (100.00) | 4591/5936 (77.34) | 1175/1536 (76.50) |
Χ2 1=0.49, P=0.48232 |
| Schizophrenia or personality disorder : Yes | 7472 (100.00) | 434/5936 (7.31) | 149/1536 (9.70) |
Χ2 1=9.68, P=0.00192 |
| Alcohol or other substance use : Yes | 7472 (100.00) | 2586/5936 (43.56) | 756/1536 (49.22) |
Χ2 1=15.78, P=0.00012 |
| Benzodiazepine or anticonvulsant use : Yes | 7472 (100.00) | 859/5936 (14.47) | 218/1536 (14.19) |
Χ2 1=0.08, P=0.78192 |
| Maternal morbidity : Yes | 7472 (100.00) | 407/5936 (6.86) | 121/1536 (7.88) |
Χ2 1=1.94, P=0.16392 |
| Anxiety and depression combined : Yes | 7472 (100.00) | 2745/5936 (46.24) | 740/1536 (48.18) |
Χ2 1=1.83, P=0.17572 |
| Back pain : Yes | 7472 (100.00) | 2030/5936 (34.20) | 498/1536 (32.42) |
Χ2 1=1.72, P=0.18972 |
| Depression : Yes | 7472 (100.00) | 2314/5936 (38.98) | 632/1536 (41.15) |
Χ2 1=2.39, P=0.12202 |
| Bipolar disorder : Yes | 7472 (100.00) | 648/5936 (10.92) | 171/1536 (11.13) |
Χ2 1=0.06, P=0.80882 |
| Other substance use : Yes | 7472 (100.00) | 2460/5936 (41.44) | 737/1536 (47.98) |
Χ2 1=21.32, P<0.00012 |
| Tobacco use : Yes | 7472 (100.00) | 4117/5936 (69.36) | 1079/1536 (70.25) |
Χ2 1=0.46, P=0.49892 |
| Med NSAIDS : Yes | 7472 (100.00) | 3667/5936 (61.78) | 935/1536 (60.87) |
Χ2 1=0.42, P=0.51652 |
| Schizophrenia psychotic disorders : Yes | 7472 (100.00) | 353/5936 (5.95) | 113/1536 (7.36) |
Χ2 1=4.15, P=0.04172 |
| Anxiety : Yes | 7472 (100.00) | 1260/5936 (21.23) | 348/1536 (22.66) |
Χ2 1=1.48, P=0.22422 |
| Med benzodiazepine use : Yes | 7472 (100.00) | 564/5936 (9.50) | 149/1536 (9.70) |
Χ2 1=0.06, P=0.81282 |
| Maternal morbidity : Yes | 7472 (100.00) | 407/5936 (6.86) | 121/1536 (7.88) |
Χ2 1=1.94, P=0.16392 |
| Dental pain : Yes | 7472 (100.00) | 224/5936 (3.77) | 74/1536 (4.82) |
Χ2 1=3.47, P=0.06232 |
| Alcohol use disorder : Yes | 7472 (100.00) | 377/5936 (6.35) | 130/1536 (8.46) |
Χ2 1=8.61, P=0.00332 |
| Med anticonvulsant use : Yes | 7472 (100.00) | 351/5936 (5.91) | 81/1536 (5.27) |
Χ2 1=0.92, P=0.33842 |
| Med muscle relaxant use : Yes | 7472 (100.00) | 264/5936 (4.45) | 107/1536 (6.97) |
Χ2 1=16.41, P=0.00012 |
| Personality disorder : Yes | 7472 (100.00) | 154/5936 (2.59) | 66/1536 (4.30) |
Χ2 1=12.38, P=0.00042 |
| Fibromyalgia : Yes | 7472 (100.00) | 299/5936 (5.04) | 84/1536 (5.47) |
Χ2 1=0.47, P=0.49412 |
| CDC SVI overall percentile ranking of all 4 themes | 7042 (94.25) | F1,7040=3.35, P=0.06733 | ||
| Median (interquartile range) | 0.57 (0.36—0.78) | 0.60 (0.38—0.80) | ||
| Range | 0.00—1.00 | 0.00—1.00 |
N is the number of non-missing value. 1Kruskal-Wallis.
2Pearson. 3Wilcoxon.
5.4.2 Three categories
| N | Only pre | Only post | Both pre and post | Test Statistic | |
|---|---|---|---|---|---|
| (N=898) | (N=638) | (N=5936) | |||
| Year of delivery | 7472 (100.00) | F2,7469=4.01, P=0.01821 | |||
| Median (interquartile range) | 2016 (2015—2018) | 2016 (2014—2019) | 2016 (2014—2018) | ||
| Range | 2007—2020 | 2007—2020 | 2007—2020 | ||
| Year of delivery as categorical | 7472 (100.00) |
Χ2 26=167.95, P<0.00012 |
|||
| 2007 | 1/898 (0.11) | 6/638 (0.94) | 25/5936 (0.42) | ||
| 2008 | 3/898 (0.33) | 15/638 (2.35) | 41/5936 (0.69) | ||
| 2009 | 10/898 (1.11) | 19/638 (2.98) | 52/5936 (0.88) | ||
| 2010 | 6/898 (0.67) | 24/638 (3.76) | 112/5936 (1.89) | ||
| 2011 | 19/898 (2.12) | 27/638 (4.23) | 146/5936 (2.46) | ||
| 2012 | 28/898 (3.12) | 19/638 (2.98) | 223/5936 (3.76) | ||
| 2013 | 40/898 (4.45) | 43/638 (6.74) | 438/5936 (7.38) | ||
| 2014 | 79/898 (8.80) | 48/638 (7.52) | 684/5936 (11.52) | ||
| 2015 | 121/898 (13.47) | 60/638 (9.40) | 821/5936 (13.83) | ||
| 2016 | 155/898 (17.26) | 61/638 (9.56) | 769/5936 (12.95) | ||
| 2017 | 124/898 (13.81) | 70/638 (10.97) | 635/5936 (10.70) | ||
| 2018 | 125/898 (13.92) | 58/638 (9.09) | 621/5936 (10.46) | ||
| 2019 | 113/898 (12.58) | 91/638 (14.26) | 663/5936 (11.17) | ||
| 2020 | 74/898 (8.24) | 97/638 (15.20) | 706/5936 (11.89) | ||
| Age at delivery | 7472 (100.00) | F2,7469=0.32, P=0.72301 | |||
| Median (interquartile range) | 27 (24—31) | 27 (24—31) | 27 (24—31) | ||
| Range | 18—43 | 17—44 | 17—44 | ||
| Number of Gestation weeks | 7472 (100.00) | F2,7469=13.25, P<0.00011 | |||
| Median (interquartile range) | 39 (37—39) | 38 (37—39) | 39 (37—39) | ||
| Range | 24—42 | 23—42 | 21—42 | ||
| Race | 7472 (100.00) |
Χ2 8=11.75, P=0.16262 |
|||
| American Indian or Alaska Native | 4/898 (0.45) | 3/638 (0.47) | 16/5936 (0.27) | ||
| Asian or Pacific Islander | 1/898 (0.11) | 1/638 (0.16) | 9/5936 (0.15) | ||
| Black of African American | 35/898 (3.90) | 22/638 (3.45) | 153/5936 (2.58) | ||
| Other or Unknown | 11/898 (1.22) | 5/638 (0.78) | 37/5936 (0.62) | ||
| White | 847/898 (94.32) | 607/638 (95.14) | 5721/5936 (96.38) | ||
| Hispanic : Not Hispanic | 7465 (99.91) | 886/895 (98.99) | 633/637 (99.37) | 5879/5933 (99.09) |
Χ2 2=0.65, P=0.72302 |
| Race/Ethnicity combined | 7472 (100.00) |
Χ2 8=15.31, P=0.05342 |
|||
| Hispanic | 9/898 (1.00) | 4/638 (0.63) | 54/5936 (0.91) | ||
| Non-Hispanic Asian | 1/898 (0.11) | 1/638 (0.16) | 9/5936 (0.15) | ||
| Non-Hispanic Black | 34/898 (3.79) | 22/638 (3.45) | 153/5936 (2.58) | ||
| Non-Hispanic Other | 13/898 (1.45) | 7/638 (1.10) | 35/5936 (0.59) | ||
| Non-Hispanic White | 841/898 (93.65) | 604/638 (94.67) | 5685/5936 (95.77) | ||
| Route of delivery : Vaginal | 7472 (100.00) | 614/898 (68.37) | 421/638 (65.99) | 3822/5936 (64.39) |
Χ2 2=5.75, P=0.05652 |
| Number of previous pregnancies | 7335 (98.17) | F2,7332=2.23, P=0.10741 | |||
| Median (interquartile range) | 2 (1—3) | 2 (1—3) | 2 (1—3) | ||
| Range | 0—19 | 0—23 | 0—23 | ||
| Final outcome | 7472 (100.00) |
Χ2 6=39.01, P<0.00012 |
|||
| Death | 3/898 (0.33) | 2/638 (0.31) | 25/5936 (0.42) | ||
| Overdose | 19/898 (2.12) | 16/638 (2.51) | 62/5936 (1.04) | ||
| Loss of enrollment | 100/898 (11.14) | 90/638 (14.11) | 519/5936 (8.74) | ||
| Censored | 776/898 (86.41) | 530/638 (83.07) | 5330/5936 (89.79) | ||
| Final outcome 3 levels | 7472 (100.00) |
Χ2 4=15.21, P=0.00432 |
|||
| Death | 3/898 (0.33) | 2/638 (0.31) | 25/5936 (0.42) | ||
| Overdose | 19/898 (2.12) | 16/638 (2.51) | 62/5936 (1.04) | ||
| Censored | 876/898 (97.55) | 620/638 (97.18) | 5849/5936 (98.53) | ||
| Total days supplied MOUD | 7472 (100.00) | F2,7469=2556.49, P<0.00011 | |||
| Median (interquartile range) | 30 (15—56) | 28 (14—33) | 108 (84—122) | ||
| Range | 1—90 | 1—70 | 7—132 | ||
| Total days supplied MOUD before delivery | 7472 (100.00) | F2,7469=2174.12, P<0.00011 | |||
| Median (interquartile range) | 30 (15—56) | 0 (0—0) | 84 (60—90) | ||
| Range | 1—90 | 0—28 | 1—90 | ||
| Total days supplied MOUD after delivery | 7472 (100.00) | F2,7469=1437.41, P<0.00011 | |||
| Median (interquartile range) | 0 (0—0) | 28 (14—33) | 30 (21—42) | ||
| Range | 0—0 | 1—42 | 0—42 | ||
| Total days supplied MOUD (method 2) | 7472 (100.00) | F2,7469=2502.29, P<0.00011 | |||
| Median (interquartile range) | 30 (15—56) | 28 (14—33) | 112 (84—129) | ||
| Range | 1—132 | 1—70 | 7—132 | ||
| Total days supplied MOUD before delivery (method 2) | 7472 (100.00) | F2,7469=2174.12, P<0.00011 | |||
| Median (interquartile range) | 30 (15—56) | 0 (0—0) | 84 (60—90) | ||
| Range | 1—90 | 0—28 | 1—90 | ||
| Total days supplied MOUD after delivery (method 2) | 7472 (100.00) | F2,7469=1572.78, P<0.00011 | |||
| Median (interquartile range) | 0 (0—0) | 28 (14—33) | 35 (24—42) | ||
| Range | 0—42 | 1—42 | 0—42 | ||
| Total days supplied MOUD (method 3) | 7472 (100.00) | F2,7469=2608.87, P<0.00011 | |||
| Median (interquartile range) | 30 (14—49) | 14 (7—25) | 100 (76—116) | ||
| Range | 1—89 | 1—41 | 7—132 | ||
| Total days supplied MOUD before delivery (method 3) | 7472 (100.00) | F2,7469=1884.96, P<0.00011 | |||
| Median (interquartile range) | 30 (14—49) | 0 (0—0) | 69 (48—80) | ||
| Range | 1—89 | 0—0 | 1—90 | ||
| Total days supplied MOUD after delivery (method 3) | 7472 (100.00) | F2,7469=2453.64, P<0.00011 | |||
| Median (interquartile range) | 0 (0—0) | 14 (7—25) | 35 (23—41) | ||
| Range | 0—0 | 1—41 | 1—42 | ||
| Avg dose pre-delivery (mg) | 7394 (98.96) | F2,7391=1043.59, P<0.00011 | |||
| Median (interquartile range) | 13.90 (8.00—16.00) | 0.00 (0.00—0.00) | 15.00 (9.94—16.00) | ||
| Range | 0.14—50.00 | 0.00—0.00 | 0.25—50.00 | ||
| Avg dose post-delivery (mg) | 7394 (98.96) | F2,7391=1408.35, P<0.00011 | |||
| Median (interquartile range) | 0.00 (0.00—0.00) | 15.76 (8.12—16.00) | 12.00 (8.00—16.00) | ||
| Range | 0.00—0.00 | 0.80—53.57 | 0.00—50.00 | ||
| Avg dose exposure (mg) | 7394 (98.96) | F2,7391=6.55, P=0.00141 | |||
| Median (interquartile range) | 13.90 (8.00—16.00) | 15.76 (8.12—16.00) | 14.04 (9.87—16.00) | ||
| Range | 0.14—50.00 | 0.80—53.57 | 0.25—50.00 | ||
| Total days buprenorphine before delivery (method 3) | 7299 (97.68) | F2,7296=1632.75, P<0.00011 | |||
| Median (interquartile range) | 30.00 (14.00—49.00) | 0.00 (0.00—0.00) | 69.00 (48.00—80.00) | ||
| Range | 1.00—89.00 | 0.00—0.00 | 0.00—90.00 | ||
| Total days buprenorphine after delivery (method 3) | 7299 (97.68) | F2,7296=2232.06, P<0.00011 | |||
| Median (interquartile range) | 0.00 (0.00—0.00) | 14.50 (7.00—25.00) | 35.00 (23.00—41.00) | ||
| Range | 0.00—0.00 | 1.00—41.00 | 0.00—42.00 | ||
| Total days supplied buprenorphine | 7299 (97.68) | F2,7296=2300.69, P<0.00011 | |||
| Median (interquartile range) | 30.00 (14.00—49.00) | 14.50 (7.00—25.00) | 100.00 (76.00—116.00) | ||
| Range | 1.00—89.00 | 1.00—41.00 | 4.00—132.00 | ||
| Avg dose BUP pre-delivery (mg) | 7298 (97.67) | F2,7295=997.58, P<0.00011 | |||
| Median (interquartile range) | 13.33 (8.00—16.00) | 0.00 (0.00—0.00) | 14.86 (9.67—16.00) | ||
| Range | 0.14—29.71 | 0.00—0.00 | 0.00—35.42 | ||
| Avg dose BUP post-delivery (mg) | 7298 (97.67) | F2,7295=1365.44, P<0.00011 | |||
| Median (interquartile range) | 0.00 (0.00—0.00) | 15.30 (8.00—16.00) | 12.00 (8.00—16.00) | ||
| Range | 0.00—0.00 | 0.80—42.67 | 0.00—33.24 | ||
| Avg dose BUP exposure (mg) | 7298 (97.67) | F2,7295=3.99, P=0.01851 | |||
| Median (interquartile range) | 13.33 (8.00—16.00) | 15.30 (8.00—16.00) | 13.98 (9.75—16.00) | ||
| Range | 0.14—29.71 | 0.80—42.67 | 0.25—34.47 | ||
| Combined pain : Yes | 7472 (100.00) | 702/898 (78.17) | 473/638 (74.14) | 4591/5936 (77.34) |
Χ2 2=3.94, P=0.13932 |
| Schizophrenia or personality disorder : Yes | 7472 (100.00) | 83/898 (9.24) | 66/638 (10.34) | 434/5936 (7.31) |
Χ2 2=10.31, P=0.00582 |
| Alcohol or other substance use : Yes | 7472 (100.00) | 441/898 (49.11) | 315/638 (49.37) | 2586/5936 (43.56) |
Χ2 2=15.79, P=0.00042 |
| Benzodiazepine or anticonvulsant use : Yes | 7472 (100.00) | 131/898 (14.59) | 87/638 (13.64) | 859/5936 (14.47) |
Χ2 2=0.35, P=0.83932 |
| Maternal morbidity : Yes | 7472 (100.00) | 69/898 (7.68) | 52/638 (8.15) | 407/5936 (6.86) |
Χ2 2=2.06, P=0.35682 |
| Anxiety and depression combined : Yes | 7472 (100.00) | 403/898 (44.88) | 337/638 (52.82) | 2745/5936 (46.24) |
Χ2 2=11.29, P=0.00352 |
| Back pain : Yes | 7472 (100.00) | 308/898 (34.30) | 190/638 (29.78) | 2030/5936 (34.20) |
Χ2 2=5.12, P=0.07732 |
| Depression : Yes | 7472 (100.00) | 338/898 (37.64) | 294/638 (46.08) | 2314/5936 (38.98) |
Χ2 2=13.52, P=0.00122 |
| Bipolar disorder : Yes | 7472 (100.00) | 110/898 (12.25) | 61/638 (9.56) | 648/5936 (10.92) |
Χ2 2=2.82, P=0.24412 |
| Other substance use : Yes | 7472 (100.00) | 434/898 (48.33) | 303/638 (47.49) | 2460/5936 (41.44) |
Χ2 2=21.43, P<0.00012 |
| Tobacco use : Yes | 7472 (100.00) | 651/898 (72.49) | 428/638 (67.08) | 4117/5936 (69.36) |
Χ2 2=5.61, P=0.06052 |
| Med NSAIDS : Yes | 7472 (100.00) | 551/898 (61.36) | 384/638 (60.19) | 3667/5936 (61.78) |
Χ2 2=0.64, P=0.72732 |
| Schizophrenia psychotic disorders : Yes | 7472 (100.00) | 64/898 (7.13) | 49/638 (7.68) | 353/5936 (5.95) |
Χ2 2=4.34, P=0.11402 |
| Anxiety : Yes | 7472 (100.00) | 208/898 (23.16) | 140/638 (21.94) | 1260/5936 (21.23) |
Χ2 2=1.81, P=0.40552 |
| Med benzodiazepine use : Yes | 7472 (100.00) | 93/898 (10.36) | 56/638 (8.78) | 564/5936 (9.50) |
Χ2 2=1.13, P=0.56742 |
| Maternal morbidity : Yes | 7472 (100.00) | 69/898 (7.68) | 52/638 (8.15) | 407/5936 (6.86) |
Χ2 2=2.06, P=0.35682 |
| Dental pain : Yes | 7472 (100.00) | 44/898 (4.90) | 30/638 (4.70) | 224/5936 (3.77) |
Χ2 2=3.51, P=0.17272 |
| Alcohol use disorder : Yes | 7472 (100.00) | 66/898 (7.35) | 64/638 (10.03) | 377/5936 (6.35) |
Χ2 2=12.85, P=0.00162 |
| Med anticonvulsant use : Yes | 7472 (100.00) | 48/898 (5.35) | 33/638 (5.17) | 351/5936 (5.91) |
Χ2 2=0.94, P=0.62602 |
| Med muscle relaxant use : Yes | 7472 (100.00) | 57/898 (6.35) | 50/638 (7.84) | 264/5936 (4.45) |
Χ2 2=18.16, P=0.00012 |
| Personality disorder : Yes | 7472 (100.00) | 35/898 (3.90) | 31/638 (4.86) | 154/5936 (2.59) |
Χ2 2=13.58, P=0.00112 |
| Fibromyalgia : Yes | 7472 (100.00) | 55/898 (6.12) | 29/638 (4.55) | 299/5936 (5.04) |
Χ2 2=2.38, P=0.30412 |
| CDC SVI overall percentile ranking of all 4 themes | 7042 (94.25) | F2,7039=2.85, P=0.05801 | |||
| Median (interquartile range) | 0.61 (0.38—0.81) | 0.58 (0.37—0.78) | 0.57 (0.36—0.78) | ||
| Range | 0.00—1.00 | 0.00—1.00 | 0.00—1.00 |
N is the number of non-missing value. 1Kruskal-Wallis.
2Pearson. 3Wilcoxon.
5.5 Histogram of MOUD days supplied
5.5.1 Before delivery up to 90 days (Method 1)
5.5.2 Before delivery up to 90 days (Method 2)
5.5.3 Before delivery up to 90 days (Method 3)
5.5.4 After delivery up to 41 days (Method 1)
5.5.5 After delivery up to 41 days (Method 3)
5.5.6 After delivery up to 41 days (Method 3)
5.5.7 Entire exposure (Method 1)
5.5.8 Entire exposure (Method 2)
5.5.9 Entire exposure (Method 3)
Survival Analysis
5.6 Kaplan Meier Plot
Call: survfit(formula = Surv(days.to.event, outcome.bin) ~ 1, data = moud)
n events median 0.95LCL 0.95UCL
[1,] 7472 127 NA NA NA
Min. 1st Qu. Median Mean 3rd Qu. Max.
2.0 97.0 185.0 178.3 261.0 323.0 | time | probability |
|---|---|
| 2 | 0.9998662 |
| 7 | 0.9997323 |
| 8 | 0.9994647 |
| 17 | 0.9993308 |
| 18 | 0.9991970 |
| 19 | 0.9990632 |
| 27 | 0.9989293 |
| 32 | 0.9987955 |
| 34 | 0.9986617 |
| 35 | 0.9983940 |
| 41 | 0.9982602 |
| 45 | 0.9979925 |
| 47 | 0.9978587 |
| 52 | 0.9977248 |
| 59 | 0.9974572 |
| 60 | 0.9973233 |
| 61 | 0.9971895 |
| 63 | 0.9970557 |
| 65 | 0.9969218 |
| 66 | 0.9967880 |
| 69 | 0.9966542 |
| 70 | 0.9965203 |
| 75 | 0.9963865 |
| 77 | 0.9962527 |
| 87 | 0.9961188 |
| 93 | 0.9959850 |
| 95 | 0.9958512 |
| 97 | 0.9957173 |
| 101 | 0.9954497 |
| 110 | 0.9953158 |
| 111 | 0.9951820 |
| 112 | 0.9950482 |
| 118 | 0.9949143 |
| 120 | 0.9947805 |
| 121 | 0.9946467 |
| 125 | 0.9945128 |
| 128 | 0.9943790 |
| 131 | 0.9942452 |
| 138 | 0.9939775 |
| 140 | 0.9938437 |
| 144 | 0.9937099 |
| 147 | 0.9935760 |
| 151 | 0.9933084 |
| 153 | 0.9931745 |
| 156 | 0.9929069 |
| 166 | 0.9927730 |
| 171 | 0.9926392 |
| 173 | 0.9925054 |
| 175 | 0.9923715 |
| 177 | 0.9922377 |
| 178 | 0.9921039 |
| 181 | 0.9919700 |
| 182 | 0.9918362 |
| 184 | 0.9917024 |
| 185 | 0.9915685 |
| 188 | 0.9913009 |
| 193 | 0.9911670 |
| 204 | 0.9910332 |
| 208 | 0.9908994 |
| 211 | 0.9907655 |
| 213 | 0.9906317 |
| 215 | 0.9904979 |
| 216 | 0.9903640 |
| 217 | 0.9900964 |
| 220 | 0.9899625 |
| 222 | 0.9898287 |
| 223 | 0.9896949 |
| 228 | 0.9894272 |
| 229 | 0.9892934 |
| 233 | 0.9891595 |
| 235 | 0.9890257 |
| 236 | 0.9888919 |
| 239 | 0.9887580 |
| 240 | 0.9884904 |
| 245 | 0.9883565 |
| 246 | 0.9880889 |
| 247 | 0.9879550 |
| 250 | 0.9878212 |
| 253 | 0.9876874 |
| 254 | 0.9875535 |
| 258 | 0.9874197 |
| 261 | 0.9871520 |
| 262 | 0.9870182 |
| 263 | 0.9868844 |
| 265 | 0.9867505 |
| 267 | 0.9866167 |
| 268 | 0.9864829 |
| 270 | 0.9863490 |
| 271 | 0.9862152 |
| 274 | 0.9859475 |
| 275 | 0.9858137 |
| 279 | 0.9856799 |
| 287 | 0.9854122 |
| 289 | 0.9852784 |
| 290 | 0.9851445 |
| 295 | 0.9850107 |
| 296 | 0.9848769 |
| 298 | 0.9846092 |
| 300 | 0.9844754 |
| 301 | 0.9843415 |
| 302 | 0.9842077 |
| 304 | 0.9840739 |
| 305 | 0.9839400 |
| 308 | 0.9836724 |
| 310 | 0.9834047 |
| 313 | 0.9832709 |
| 316 | 0.9831370 |
| 319 | 0.9830032 |
| 323 | 0.9830032 |
5.7 Time to event for overdose and death
| n | missing | distinct | Info | Mean | pMedian | Gmd | .05 | .10 | .25 | .50 | .75 | .90 | .95 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 127 | 0 | 108 | 1 | 178.4 | 179 | 108.1 | 21.4 | 43.4 | 99.0 | 188.0 | 261.0 | 298.0 | 307.1 |
| n | missing | distinct | Info | Mean | pMedian | Gmd | .05 | .10 | .25 | .50 | .75 | .90 | .95 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 30 | 0 | 30 | 1 | 153.9 | 154 | 112.5 | 17.9 | 30.7 | 59.5 | 163.5 | 239.0 | 275.4 | 285.0 |
| n | missing | distinct | Info | Mean | pMedian | Gmd | .05 | .10 | .25 | .50 | .75 | .90 | .95 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 97 | 0 | 88 | 1 | 186 | 186.5 | 106.1 | 32.6 | 54.2 | 111.0 | 208.0 | 263.0 | 300.4 | 308.4 |
6 Multivariable Cox PH model
6.1 Linear continuous terms
Effects Response: Surv(days.to.event, outcome.bin) | |||||||
| Low | High | Δ | Effect | S.E. | Lower 0.95 | Upper 0.95 | |
|---|---|---|---|---|---|---|---|
| Year of delivery | 2016 | 2018 | 2 | 0.406700 | 0.09689 | 0.21680 | 0.59660 |
| Hazard Ratio | 2016 | 2018 | 2 | 1.502000 | 1.24200 | 1.81600 | |
| Total days supplied MOUD (method 3) | 1 | 31 | 30 | -0.192300 | 0.06460 | -0.31890 | -0.06565 |
| Hazard Ratio | 1 | 31 | 30 | 0.825100 | 0.72700 | 0.93650 | |
| Age at delivery | 27 | 31 | 4 | -0.092200 | 0.07947 | -0.24800 | 0.06357 |
| Hazard Ratio | 27 | 31 | 4 | 0.911900 | 0.78040 | 1.06600 | |
| Number of Gestation weeks | 39 | 37 | -2 | 0.071680 | 0.07413 | -0.07361 | 0.21700 |
| Hazard Ratio | 39 | 37 | -2 | 1.074000 | 0.92900 | 1.24200 | |
| Route of delivery --- Cesarean:Vaginal | 2 | 1 | -0.005726 | 0.19320 | -0.38440 | 0.37300 | |
| Hazard Ratio | 2 | 1 | 0.994300 | 0.68080 | 1.45200 | ||
| Combined pain --- Yes:No | 1 | 2 | -0.235200 | 0.19800 | -0.62320 | 0.15290 | |
| Hazard Ratio | 1 | 2 | 0.790400 | 0.53620 | 1.16500 | ||
| Alcohol or other substance use --- Yes:No | 1 | 2 | 0.324700 | 0.18550 | -0.03882 | 0.68820 | |
| Hazard Ratio | 1 | 2 | 1.384000 | 0.96190 | 1.99000 | ||
| Benzodiazepine or anticonvulsant use --- Yes:No | 1 | 2 | 0.355400 | 0.22380 | -0.08325 | 0.79410 | |
| Hazard Ratio | 1 | 2 | 1.427000 | 0.92010 | 2.21200 | ||
| Anxiety and depression combined --- Yes:No | 1 | 2 | 0.635600 | 0.20080 | 0.24200 | 1.02900 | |
| Hazard Ratio | 1 | 2 | 1.888000 | 1.27400 | 2.79900 | ||
| Maternal morbidity --- Yes:No | 1 | 2 | -0.001079 | 0.37710 | -0.74020 | 0.73810 | |
| Hazard Ratio | 1 | 2 | 0.998900 | 0.47700 | 2.09200 | ||
Wald Statistics for Surv(days.to.event, outcome.bin) | |||
| χ2 | d.f. | P | |
|---|---|---|---|
| Year of delivery | 17.59 | 1 | <0.0001 |
| Total days supplied MOUD (method 3) | 8.85 | 1 | 0.0029 |
| Age at delivery | 1.35 | 1 | 0.2456 |
| Route of delivery | 0.00 | 1 | 0.9764 |
| Number of Gestation weeks | 0.94 | 1 | 0.3331 |
| Combined pain | 1.41 | 1 | 0.2350 |
| Alcohol or other substance use | 3.07 | 1 | 0.0800 |
| Benzodiazepine or anticonvulsant use | 2.52 | 1 | 0.1122 |
| Anxiety and depression combined | 10.01 | 1 | 0.0016 |
| Maternal morbidity | 0.00 | 1 | 0.9977 |
| TOTAL | 61.67 | 10 | <0.0001 |
6.1.1 Univariable HR
Effects Response: Surv(days.to.event, outcome.bin) | |||||||
| Low | High | Δ | Effect | S.E. | Lower 0.95 | Upper 0.95 | |
|---|---|---|---|---|---|---|---|
| Total days supplied MOUD (method 3) | 1 | 31 | 30 | -0.2263 | 0.06572 | -0.3551 | -0.09746 |
| Hazard Ratio | 1 | 31 | 30 | 0.7975 | 0.7011 | 0.90710 | |
Wald Statistics for Surv(days.to.event, outcome.bin) | |||
| χ2 | d.f. | P | |
|---|---|---|---|
| Total days supplied MOUD (method 3) | 11.85 | 1 | 0.0006 |
| TOTAL | 11.85 | 1 | 0.0006 |
6.2 With splines
Effects Response: Surv(days.to.event, outcome.bin) | |||||||
| Low | High | Δ | Effect | S.E. | Lower 0.95 | Upper 0.95 | |
|---|---|---|---|---|---|---|---|
| Year of delivery | 2016 | 2018 | 2 | 0.467700 | 0.09835 | 0.27490 | 0.66050 |
| Hazard Ratio | 2016 | 2018 | 2 | 1.596000 | 1.31600 | 1.93600 | |
| Total days supplied MOUD (method 3) | 1 | 31 | 30 | -0.194100 | 0.06405 | -0.31960 | -0.06857 |
| Hazard Ratio | 1 | 31 | 30 | 0.823600 | 0.72640 | 0.93370 | |
| Age at delivery | 27 | 31 | 4 | -0.094170 | 0.07917 | -0.24930 | 0.06100 |
| Hazard Ratio | 27 | 31 | 4 | 0.910100 | 0.77930 | 1.06300 | |
| Number of Gestation weeks | 39 | 37 | -2 | 0.069940 | 0.07470 | -0.07647 | 0.21640 |
| Hazard Ratio | 39 | 37 | -2 | 1.072000 | 0.92640 | 1.24200 | |
| Route of delivery --- Cesarean:Vaginal | 2 | 1 | -0.005208 | 0.19310 | -0.38360 | 0.37320 | |
| Hazard Ratio | 2 | 1 | 0.994800 | 0.68140 | 1.45200 | ||
| Combined pain --- Yes:No | 1 | 2 | -0.246600 | 0.19930 | -0.63730 | 0.14410 | |
| Hazard Ratio | 1 | 2 | 0.781400 | 0.52870 | 1.15500 | ||
| Alcohol or other substance use --- Yes:No | 1 | 2 | 0.325300 | 0.18570 | -0.03873 | 0.68940 | |
| Hazard Ratio | 1 | 2 | 1.384000 | 0.96200 | 1.99200 | ||
| Benzodiazepine or anticonvulsant use --- Yes:No | 1 | 2 | 0.373200 | 0.22820 | -0.07416 | 0.82050 | |
| Hazard Ratio | 1 | 2 | 1.452000 | 0.92850 | 2.27200 | ||
| Anxiety and depression combined --- Yes:No | 1 | 2 | 0.640100 | 0.20040 | 0.24730 | 1.03300 | |
| Hazard Ratio | 1 | 2 | 1.897000 | 1.28100 | 2.80900 | ||
| Maternal morbidity --- Yes:No | 1 | 2 | -0.020030 | 0.37720 | -0.75930 | 0.71930 | |
| Hazard Ratio | 1 | 2 | 0.980200 | 0.46800 | 2.05300 | ||
Wald Statistics for Surv(days.to.event, outcome.bin) | |||
| χ2 | d.f. | P | |
|---|---|---|---|
| Year of delivery | 25.25 | 2 | <0.0001 |
| Nonlinear | 1.17 | 1 | 0.2797 |
| Total days supplied MOUD (method 3) | 9.18 | 1 | 0.0024 |
| Age at delivery | 1.42 | 1 | 0.2338 |
| Route of delivery | 0.00 | 1 | 0.9785 |
| Number of Gestation weeks | 0.88 | 1 | 0.3486 |
| Combined pain | 1.53 | 1 | 0.2161 |
| Alcohol or other substance use | 3.07 | 1 | 0.0798 |
| Benzodiazepine or anticonvulsant use | 2.68 | 1 | 0.1019 |
| Anxiety and depression combined | 10.19 | 1 | 0.0014 |
| Maternal morbidity | 0.00 | 1 | 0.9576 |
| TOTAL | 71.22 | 11 | <0.0001 |
6.3 Linear model (only buprenorphine)
Effects Response: Surv(days.to.event, outcome.bin) | |||||||
| Low | High | Δ | Effect | S.E. | Lower 0.95 | Upper 0.95 | |
|---|---|---|---|---|---|---|---|
| Year of delivery | 2016 | 2018 | 2 | 0.41000 | 0.09798 | 0.21800 | 0.60200 |
| Hazard Ratio | 2016 | 2018 | 2 | 1.50700 | 1.24400 | 1.82600 | |
| Total days supplied buprenorphine | 1 | 31 | 30 | -0.24020 | 0.06656 | -0.37070 | -0.10970 |
| Hazard Ratio | 1 | 31 | 30 | 0.78650 | 0.69030 | 0.89610 | |
| Age at delivery | 27 | 31 | 4 | -0.08383 | 0.07952 | -0.23970 | 0.07202 |
| Hazard Ratio | 27 | 31 | 4 | 0.91960 | 0.78690 | 1.07500 | |
| Number of Gestation weeks | 39 | 37 | -2 | 0.07175 | 0.07370 | -0.07269 | 0.21620 |
| Hazard Ratio | 39 | 37 | -2 | 1.07400 | 0.92990 | 1.24100 | |
| Route of delivery --- Cesarean:Vaginal | 2 | 1 | -0.05152 | 0.19580 | -0.43520 | 0.33220 | |
| Hazard Ratio | 2 | 1 | 0.94980 | 0.64710 | 1.39400 | ||
| Combined pain --- Yes:No | 1 | 2 | -0.24090 | 0.19880 | -0.63040 | 0.14870 | |
| Hazard Ratio | 1 | 2 | 0.78590 | 0.53240 | 1.16000 | ||
| Alcohol or other substance use --- Yes:No | 1 | 2 | 0.38810 | 0.18630 | 0.02293 | 0.75330 | |
| Hazard Ratio | 1 | 2 | 1.47400 | 1.02300 | 2.12400 | ||
| Benzodiazepine or anticonvulsant use --- Yes:No | 1 | 2 | 0.36220 | 0.22470 | -0.07817 | 0.80260 | |
| Hazard Ratio | 1 | 2 | 1.43700 | 0.92480 | 2.23100 | ||
| Anxiety and depression combined --- Yes:No | 1 | 2 | 0.65110 | 0.20130 | 0.25650 | 1.04600 | |
| Hazard Ratio | 1 | 2 | 1.91800 | 1.29200 | 2.84500 | ||
| Maternal morbidity --- Yes:No | 1 | 2 | -0.01000 | 0.37850 | -0.75180 | 0.73170 | |
| Hazard Ratio | 1 | 2 | 0.99000 | 0.47150 | 2.07900 | ||
Wald Statistics for Surv(days.to.event, outcome.bin) | |||
| χ2 | d.f. | P | |
|---|---|---|---|
| Year of delivery | 17.48 | 1 | <0.0001 |
| Total days supplied buprenorphine | 13.01 | 1 | 0.0003 |
| Age at delivery | 1.11 | 1 | 0.2914 |
| Route of delivery | 0.07 | 1 | 0.7925 |
| Number of Gestation weeks | 0.95 | 1 | 0.3297 |
| Combined pain | 1.47 | 1 | 0.2257 |
| Alcohol or other substance use | 4.34 | 1 | 0.0372 |
| Benzodiazepine or anticonvulsant use | 2.60 | 1 | 0.1068 |
| Anxiety and depression combined | 10.44 | 1 | 0.0012 |
| Maternal morbidity | 0.00 | 1 | 0.9789 |
| TOTAL | 66.41 | 10 | <0.0001 |
6.3.1 Univariate
Effects Response: Surv(days.to.event, outcome.bin) | |||||||
| Low | High | Δ | Effect | S.E. | Lower 0.95 | Upper 0.95 | |
|---|---|---|---|---|---|---|---|
| Total days supplied buprenorphine | 1 | 31 | 30 | -0.2751 | 0.06795 | -0.4082 | -0.1419 |
| Hazard Ratio | 1 | 31 | 30 | 0.7595 | 0.6648 | 0.8677 | |
Wald Statistics for Surv(days.to.event, outcome.bin) | |||
| χ2 | d.f. | P | |
|---|---|---|---|
| Total days supplied buprenorphine | 16.37 | 1 | <0.0001 |
| TOTAL | 16.37 | 1 | <0.0001 |
By MOUD timing
7 Survival analysis
7.1 KM Curves
| time | probability |
|---|---|
| 2 | 0.9988864 |
| 8 | 0.9977728 |
| 19 | 0.9966592 |
| 32 | 0.9955457 |
| 45 | 0.9944321 |
| 70 | 0.9933185 |
| 97 | 0.9922049 |
| 101 | 0.9910913 |
| 111 | 0.9899777 |
| 125 | 0.9888641 |
| 131 | 0.9877506 |
| 173 | 0.9866370 |
| 177 | 0.9855234 |
| 217 | 0.9844098 |
| 222 | 0.9832962 |
| 240 | 0.9821826 |
| 258 | 0.9810690 |
| 261 | 0.9799555 |
| 270 | 0.9788419 |
| 274 | 0.9777283 |
| 287 | 0.9766147 |
| 310 | 0.9755011 |
| 323 | 0.9755011 |
| 27 | 0.9984326 |
| 35 | 0.9968652 |
| 77 | 0.9952978 |
| 87 | 0.9937304 |
| 101 | 0.9921630 |
| 118 | 0.9905956 |
| 138 | 0.9890282 |
| 147 | 0.9874608 |
| 166 | 0.9858934 |
| 193 | 0.9843260 |
| 213 | 0.9827586 |
| 215 | 0.9811912 |
| 217 | 0.9796238 |
| 245 | 0.9780564 |
| 295 | 0.9764890 |
| 300 | 0.9749216 |
| 301 | 0.9733542 |
| 319 | 0.9717868 |
| 323 | 0.9717868 |
| 7 | 0.9998315 |
| 8 | 0.9996631 |
| 17 | 0.9994946 |
| 18 | 0.9993261 |
| 34 | 0.9991577 |
| 35 | 0.9989892 |
| 41 | 0.9988208 |
| 45 | 0.9986523 |
| 47 | 0.9984838 |
| 52 | 0.9983154 |
| 59 | 0.9979784 |
| 60 | 0.9978100 |
| 61 | 0.9976415 |
| 63 | 0.9974730 |
| 65 | 0.9973046 |
| 66 | 0.9971361 |
| 69 | 0.9969677 |
| 75 | 0.9967992 |
| 93 | 0.9966307 |
| 95 | 0.9964623 |
| 110 | 0.9962938 |
| 112 | 0.9961253 |
| 120 | 0.9959569 |
| 121 | 0.9957884 |
| 128 | 0.9956199 |
| 138 | 0.9954515 |
| 140 | 0.9952830 |
| 144 | 0.9951146 |
| 151 | 0.9947776 |
| 153 | 0.9946092 |
| 156 | 0.9942722 |
| 171 | 0.9941038 |
| 175 | 0.9939353 |
| 178 | 0.9937668 |
| 181 | 0.9935984 |
| 182 | 0.9934299 |
| 184 | 0.9932615 |
| 185 | 0.9930930 |
| 188 | 0.9927561 |
| 204 | 0.9925876 |
| 208 | 0.9924191 |
| 211 | 0.9922507 |
| 216 | 0.9920822 |
| 220 | 0.9919137 |
| 223 | 0.9917453 |
| 228 | 0.9914084 |
| 229 | 0.9912399 |
| 233 | 0.9910714 |
| 235 | 0.9909030 |
| 236 | 0.9907345 |
| 239 | 0.9905660 |
| 240 | 0.9903976 |
| 246 | 0.9900606 |
| 247 | 0.9898922 |
| 250 | 0.9897237 |
| 253 | 0.9895553 |
| 254 | 0.9893868 |
| 261 | 0.9892183 |
| 262 | 0.9890499 |
| 263 | 0.9888814 |
| 265 | 0.9887129 |
| 267 | 0.9885445 |
| 268 | 0.9883760 |
| 271 | 0.9882075 |
| 274 | 0.9880391 |
| 275 | 0.9878706 |
| 279 | 0.9877022 |
| 287 | 0.9875337 |
| 289 | 0.9873652 |
| 290 | 0.9871968 |
| 296 | 0.9870283 |
| 298 | 0.9866914 |
| 302 | 0.9865229 |
| 304 | 0.9863544 |
| 305 | 0.9861860 |
| 308 | 0.9858491 |
| 310 | 0.9856806 |
| 313 | 0.9855121 |
| 316 | 0.9853437 |
| 323 | 0.9853437 |
7.2 Log-Rank Test
Call:
survdiff(formula = Surv(days.to.event, outcome.bin) ~ moud.both3div,
data = moud)
N Observed Expected (O-E)^2/E (O-E)^2/V
moud.both3div=Only pre 898 22 15.2 3.06 3.48
moud.both3div=Only post 638 18 10.8 4.83 5.28
moud.both3div=Both pre and post 5936 87 101.0 1.95 9.54
Chisq= 9.8 on 2 degrees of freedom, p= 0.007 7.3 Multivariable Cox PH model
Linear continuous terms (timing + days)
Effects Response: Surv(days.to.event, outcome.bin) | |||||||
| Low | High | Δ | Effect | S.E. | Lower 0.95 | Upper 0.95 | |
|---|---|---|---|---|---|---|---|
| Total days supplied MOUD (method 3) | 1 | 31 | 30 | -0.142500 | 0.09738 | -0.33340 | 0.04834 |
| Hazard Ratio | 1 | 31 | 30 | 0.867200 | 0.71650 | 1.05000 | |
| Year of delivery | 2016 | 2018 | 2 | 0.405800 | 0.09657 | 0.21660 | 0.59510 |
| Hazard Ratio | 2016 | 2018 | 2 | 1.501000 | 1.24200 | 1.81300 | |
| Age at delivery | 27 | 31 | 4 | -0.095060 | 0.07930 | -0.25050 | 0.06038 |
| Hazard Ratio | 27 | 31 | 4 | 0.909300 | 0.77840 | 1.06200 | |
| Number of Gestation weeks | 39 | 37 | -2 | 0.069880 | 0.07310 | -0.07339 | 0.21310 |
| Hazard Ratio | 39 | 37 | -2 | 1.072000 | 0.92920 | 1.23800 | |
| MOUD receipt timing --- Only pre:Both pre and post | 3 | 1 | 0.198600 | 0.31710 | -0.42290 | 0.82000 | |
| Hazard Ratio | 3 | 1 | 1.220000 | 0.65510 | 2.27100 | ||
| MOUD receipt timing --- Only post:Both pre and post | 3 | 2 | 0.205500 | 0.34720 | -0.47500 | 0.88610 | |
| Hazard Ratio | 3 | 2 | 1.228000 | 0.62190 | 2.42600 | ||
| Route of delivery --- Cesarean:Vaginal | 2 | 1 | -0.008465 | 0.19370 | -0.38800 | 0.37110 | |
| Hazard Ratio | 2 | 1 | 0.991600 | 0.67840 | 1.44900 | ||
| Combined pain --- No:Yes | 2 | 1 | 0.233900 | 0.19810 | -0.15450 | 0.62220 | |
| Hazard Ratio | 2 | 1 | 1.263000 | 0.85690 | 1.86300 | ||
| Alcohol or other substance use --- Yes:No | 1 | 2 | 0.328700 | 0.18510 | -0.03412 | 0.69160 | |
| Hazard Ratio | 1 | 2 | 1.389000 | 0.96650 | 1.99700 | ||
| Benzodiazepine or anticonvulsant use --- Yes:No | 1 | 2 | 0.355500 | 0.22380 | -0.08322 | 0.79410 | |
| Hazard Ratio | 1 | 2 | 1.427000 | 0.92010 | 2.21300 | ||
| Anxiety and depression combined --- Yes:No | 1 | 2 | 0.637800 | 0.19940 | 0.24710 | 1.02900 | |
| Hazard Ratio | 1 | 2 | 1.892000 | 1.28000 | 2.79700 | ||
| Maternal morbidity --- Yes:No | 1 | 2 | -0.007480 | 0.37660 | -0.74570 | 0.73070 | |
| Hazard Ratio | 1 | 2 | 0.992500 | 0.47440 | 2.07700 | ||
Wald Statistics for Surv(days.to.event, outcome.bin) | |||
| χ2 | d.f. | P | |
|---|---|---|---|
| MOUD receipt timing | 0.48 | 2 | 0.7870 |
| Total days supplied MOUD (method 3) | 2.14 | 1 | 0.1432 |
| Year of delivery | 17.64 | 1 | <0.0001 |
| Age at delivery | 1.44 | 1 | 0.2302 |
| Route of delivery | 0.00 | 1 | 0.9652 |
| Number of Gestation weeks | 0.92 | 1 | 0.3385 |
| Combined pain | 1.39 | 1 | 0.2380 |
| Alcohol or other substance use | 3.15 | 1 | 0.0757 |
| Benzodiazepine or anticonvulsant use | 2.52 | 1 | 0.1121 |
| Anxiety and depression combined | 10.23 | 1 | 0.0014 |
| Maternal morbidity | 0.00 | 1 | 0.9841 |
| TOTAL | 64.13 | 12 | <0.0001 |
Timing only
Effects Response: Surv(days.to.event, outcome.bin) | |||||||
| Low | High | Δ | Effect | S.E. | Lower 0.95 | Upper 0.95 | |
|---|---|---|---|---|---|---|---|
| Year of delivery | 2016 | 2018 | 2 | 0.40600 | 0.09581 | 0.218300 | 0.59380 |
| Hazard Ratio | 2016 | 2018 | 2 | 1.50100 | 1.244000 | 1.81100 | |
| Age at delivery | 27 | 31 | 4 | -0.10250 | 0.08031 | -0.259900 | 0.05489 |
| Hazard Ratio | 27 | 31 | 4 | 0.90260 | 0.771100 | 1.05600 | |
| Number of Gestation weeks | 39 | 37 | -2 | 0.07466 | 0.07228 | -0.067000 | 0.21630 |
| Hazard Ratio | 39 | 37 | -2 | 1.07800 | 0.935200 | 1.24200 | |
| MOUD receipt timing --- Only pre:Both pre and post | 3 | 1 | 0.47820 | 0.23970 | 0.008477 | 0.94790 | |
| Hazard Ratio | 3 | 1 | 1.61300 | 1.009000 | 2.58000 | ||
| MOUD receipt timing --- Only post:Both pre and post | 3 | 2 | 0.55420 | 0.25520 | 0.054010 | 1.05400 | |
| Hazard Ratio | 3 | 2 | 1.74100 | 1.055000 | 2.87000 | ||
| Route of delivery --- Cesarean:Vaginal | 2 | 1 | -0.02199 | 0.19260 | -0.399500 | 0.35560 | |
| Hazard Ratio | 2 | 1 | 0.97830 | 0.670600 | 1.42700 | ||
| Combined pain --- No:Yes | 2 | 1 | 0.23320 | 0.19820 | -0.155300 | 0.62160 | |
| Hazard Ratio | 2 | 1 | 1.26300 | 0.856200 | 1.86200 | ||
| Alcohol or other substance use --- Yes:No | 1 | 2 | 0.35440 | 0.18430 | -0.006726 | 0.71560 | |
| Hazard Ratio | 1 | 2 | 1.42500 | 0.993300 | 2.04500 | ||
| Benzodiazepine or anticonvulsant use --- Yes:No | 1 | 2 | 0.35410 | 0.22380 | -0.084660 | 0.79280 | |
| Hazard Ratio | 1 | 2 | 1.42500 | 0.918800 | 2.21000 | ||
| Anxiety and depression combined --- Yes:No | 1 | 2 | 0.63990 | 0.19910 | 0.249800 | 1.03000 | |
| Hazard Ratio | 1 | 2 | 1.89600 | 1.284000 | 2.80100 | ||
| Maternal morbidity --- Yes:No | 1 | 2 | -0.01368 | 0.37620 | -0.751000 | 0.72370 | |
| Hazard Ratio | 1 | 2 | 0.98640 | 0.471900 | 2.06200 | ||
Wald Statistics for Surv(days.to.event, outcome.bin) | |||
| χ2 | d.f. | P | |
|---|---|---|---|
| MOUD receipt timing | 7.27 | 2 | 0.0264 |
| Year of delivery | 17.94 | 1 | <0.0001 |
| Age at delivery | 1.63 | 1 | 0.2013 |
| Route of delivery | 0.01 | 1 | 0.9092 |
| Number of Gestation weeks | 1.07 | 1 | 0.3010 |
| Combined pain | 1.38 | 1 | 0.2394 |
| Alcohol or other substance use | 3.70 | 1 | 0.0544 |
| Benzodiazepine or anticonvulsant use | 2.50 | 1 | 0.1136 |
| Anxiety and depression combined | 10.33 | 1 | 0.0013 |
| Maternal morbidity | 0.00 | 1 | 0.9710 |
| TOTAL | 61.12 | 11 | <0.0001 |
Linear continuous terms (timing + days BUP)
Effects Response: Surv(days.to.event, outcome.bin) | |||||||
| Low | High | Δ | Effect | S.E. | Lower 0.95 | Upper 0.95 | |
|---|---|---|---|---|---|---|---|
| Total days supplied buprenorphine | 1 | 31 | 30 | -0.17740 | 0.10010 | -0.37370 | 0.01879 |
| Hazard Ratio | 1 | 31 | 30 | 0.83740 | 0.68820 | 1.01900 | |
| Year of delivery | 2014 | 2018 | 4 | 0.81690 | 0.19360 | 0.43750 | 1.19600 |
| Hazard Ratio | 2014 | 2018 | 4 | 2.26300 | 1.54900 | 3.30800 | |
| Age at delivery | 25 | 35 | 10 | -0.21850 | 0.19860 | -0.60770 | 0.17070 |
| Hazard Ratio | 25 | 35 | 10 | 0.80370 | 0.54460 | 1.18600 | |
| Number of Gestation weeks | 37 | 39 | 2 | -0.06631 | 0.07196 | -0.20740 | 0.07473 |
| Hazard Ratio | 37 | 39 | 2 | 0.93580 | 0.81270 | 1.07800 | |
| MOUD receipt timing --- Only pre:Both pre and post | 3 | 1 | 0.17510 | 0.32130 | -0.45470 | 0.80500 | |
| Hazard Ratio | 3 | 1 | 1.19100 | 0.63470 | 2.23700 | ||
| MOUD receipt timing --- Only post:Both pre and post | 3 | 2 | 0.34510 | 0.35100 | -0.34290 | 1.03300 | |
| Hazard Ratio | 3 | 2 | 1.41200 | 0.70970 | 2.81000 | ||
| Route of delivery --- Cesarean:Vaginal | 2 | 1 | -0.05573 | 0.19610 | -0.44000 | 0.32860 | |
| Hazard Ratio | 2 | 1 | 0.94580 | 0.64400 | 1.38900 | ||
| Combined pain --- No:Yes | 2 | 1 | 0.23430 | 0.19910 | -0.15600 | 0.62460 | |
| Hazard Ratio | 2 | 1 | 1.26400 | 0.85550 | 1.86800 | ||
| Alcohol or other substance use --- Yes:No | 1 | 2 | 0.40080 | 0.18590 | 0.03634 | 0.76530 | |
| Hazard Ratio | 1 | 2 | 1.49300 | 1.03700 | 2.15000 | ||
| Benzodiazepine or anticonvulsant use --- Yes:No | 1 | 2 | 0.36230 | 0.22480 | -0.07839 | 0.80300 | |
| Hazard Ratio | 1 | 2 | 1.43700 | 0.92460 | 2.23200 | ||
| Anxiety and depression combined --- Yes:No | 1 | 2 | 0.65390 | 0.20040 | 0.26120 | 1.04700 | |
| Hazard Ratio | 1 | 2 | 1.92300 | 1.29800 | 2.84800 | ||
| Maternal morbidity --- Yes:No | 1 | 2 | -0.02123 | 0.37770 | -0.76150 | 0.71910 | |
| Hazard Ratio | 1 | 2 | 0.97900 | 0.46690 | 2.05300 | ||
Wald Statistics for Surv(days.to.event, outcome.bin) | |||
| χ2 | d.f. | P | |
|---|---|---|---|
| MOUD receipt timing | 0.97 | 2 | 0.6157 |
| Total days supplied buprenorphine | 3.14 | 1 | 0.0763 |
| Year of delivery | 17.78 | 1 | <0.0001 |
| Age at delivery | 1.21 | 1 | 0.2709 |
| Route of delivery | 0.08 | 1 | 0.7764 |
| Number of Gestation weeks | 0.85 | 1 | 0.3561 |
| Combined pain | 1.38 | 1 | 0.2395 |
| Alcohol or other substance use | 4.65 | 1 | 0.0311 |
| Benzodiazepine or anticonvulsant use | 2.60 | 1 | 0.1070 |
| Anxiety and depression combined | 10.64 | 1 | 0.0011 |
| Maternal morbidity | 0.00 | 1 | 0.9551 |
| TOTAL | 70.28 | 12 | <0.0001 |
Timing only BUP
Effects Response: Surv(days.to.event, outcome.bin) | |||||||
| Low | High | Δ | Effect | S.E. | Lower 0.95 | Upper 0.95 | |
|---|---|---|---|---|---|---|---|
| Year of delivery | 2014 | 2018 | 4 | 0.81930 | 0.19160 | 0.44380 | 1.19500 |
| Hazard Ratio | 2014 | 2018 | 4 | 2.26900 | 1.55900 | 3.30300 | |
| Age at delivery | 25 | 35 | 10 | -0.24100 | 0.20120 | -0.63530 | 0.15330 |
| Hazard Ratio | 25 | 35 | 10 | 0.78590 | 0.52980 | 1.16600 | |
| Number of Gestation weeks | 37 | 39 | 2 | -0.07246 | 0.07101 | -0.21160 | 0.06673 |
| Hazard Ratio | 37 | 39 | 2 | 0.93010 | 0.80930 | 1.06900 | |
| MOUD receipt timing --- Only pre:Both pre and post | 3 | 1 | 0.52130 | 0.24070 | 0.04942 | 0.99310 | |
| Hazard Ratio | 3 | 1 | 1.68400 | 1.05100 | 2.70000 | ||
| MOUD receipt timing --- Only post:Both pre and post | 3 | 2 | 0.77540 | 0.25690 | 0.27180 | 1.27900 | |
| Hazard Ratio | 3 | 2 | 2.17200 | 1.31200 | 3.59300 | ||
| Route of delivery --- Cesarean:Vaginal | 2 | 1 | -0.07435 | 0.19530 | -0.45710 | 0.30840 | |
| Hazard Ratio | 2 | 1 | 0.92830 | 0.63310 | 1.36100 | ||
| Combined pain --- No:Yes | 2 | 1 | 0.23410 | 0.19920 | -0.15640 | 0.62460 | |
| Hazard Ratio | 2 | 1 | 1.26400 | 0.85520 | 1.86800 | ||
| Alcohol or other substance use --- Yes:No | 1 | 2 | 0.43350 | 0.18580 | 0.06937 | 0.79770 | |
| Hazard Ratio | 1 | 2 | 1.54300 | 1.07200 | 2.22000 | ||
| Benzodiazepine or anticonvulsant use --- Yes:No | 1 | 2 | 0.36170 | 0.22480 | -0.07900 | 0.80230 | |
| Hazard Ratio | 1 | 2 | 1.43600 | 0.92400 | 2.23100 | ||
| Anxiety and depression combined --- Yes:No | 1 | 2 | 0.65680 | 0.20000 | 0.26490 | 1.04900 | |
| Hazard Ratio | 1 | 2 | 1.92900 | 1.30300 | 2.85400 | ||
| Maternal morbidity --- Yes:No | 1 | 2 | -0.02996 | 0.37720 | -0.76920 | 0.70930 | |
| Hazard Ratio | 1 | 2 | 0.97050 | 0.46340 | 2.03300 | ||
Wald Statistics for Surv(days.to.event, outcome.bin) | |||
| χ2 | d.f. | P | |
|---|---|---|---|
| MOUD receipt timing | 11.65 | 2 | 0.0029 |
| Year of delivery | 18.27 | 1 | <0.0001 |
| Age at delivery | 1.44 | 1 | 0.2307 |
| Route of delivery | 0.14 | 1 | 0.7035 |
| Number of Gestation weeks | 1.04 | 1 | 0.3068 |
| Combined pain | 1.38 | 1 | 0.2402 |
| Alcohol or other substance use | 5.45 | 1 | 0.0196 |
| Benzodiazepine or anticonvulsant use | 2.59 | 1 | 0.1076 |
| Anxiety and depression combined | 10.78 | 1 | 0.0010 |
| Maternal morbidity | 0.01 | 1 | 0.9366 |
| TOTAL | 67.10 | 11 | <0.0001 |
8 Sensitivity analysis 2007-2018
8.1 Descriptive Statistics
- There are 5728 pregnancies in 5049 unique individuals
N Overall (N=5728) Year of delivery 5728 (100.00) Median (interquartile range) 2015 (2014—2017) Range 2007—2018 Age at delivery 5728 (100.00) Median (interquartile range) 27 (24—30) Range 17—44 Number of Gestation weeks 5728 (100.00) Median (interquartile range) 39 (37—39) Range 21—42 Race 5728 (100.00) American Indian or Alaska Native 18/5728 (0.31) Asian or Pacific Islander 8/5728 (0.14) Black of African American 140/5728 (2.44) Other or Unknown 41/5728 (0.72) White 5521/5728 (96.39) Hispanic : Not Hispanic 5721 (99.88) 5675/5721 (99.20) Race/Ethnicity combined 5728 (100.00) Hispanic 46/5728 (0.80) Non-Hispanic Asian 8/5728 (0.14) Non-Hispanic Black 139/5728 (2.43) Non-Hispanic Other 45/5728 (0.79) Non-Hispanic White 5490/5728 (95.84) Route of delivery : Vaginal 5728 (100.00) 3744/5728 (65.36) Number of previous pregnancies 5596 (97.70) Median (interquartile range) 2 (1—3) Range 0—23 Final outcome 5728 (100.00) Death 20/5728 (0.35) Overdose 56/5728 (0.98) Loss of enrollment 671/5728 (11.71) Censored 4981/5728 (86.96) Final outcome (w/o all payer data) 5728 (100.00) Death 8/5728 (0.14) Overdose 51/5728 (0.89) Loss of enrollment 688/5728 (12.01) Censored 4981/5728 (86.96) Total days supplied MOUD 5728 (100.00) Median (interquartile range) 93 (56—120) Range 1—132 Total days supplied MOUD before delivery 5728 (100.00) Median (interquartile range) 74 (36—90) Range 0—90 Total days supplied MOUD after delivery 5728 (100.00) Median (interquartile range) 29 (7—41) Range 0—42 Total days supplied MOUD (method 2) 5728 (100.00) Median (interquartile range) 98 (56—122) Range 1—132 Total days supplied MOUD before delivery (method 2) 5728 (100.00) Median (interquartile range) 74 (36—90) Range 0—90 Total days supplied MOUD after delivery (method 2) 5728 (100.00) Median (interquartile range) 30 (12—42) Range 0—42 Total days supplied MOUD (method 3) 5728 (100.00) Median (interquartile range) 88 (49—110) Range 1—132 Total days supplied MOUD before delivery (method 3) 5728 (100.00) Median (interquartile range) 62 (30—77) Range 0—90 Total days supplied MOUD after delivery (method 3) 5728 (100.00) Median (interquartile range) 30 (13—40) Range 0—42 Avg dose pre-delivery (mg) 5669 (98.97) Median (interquartile range) 14.55 (8.00—16.00) Range 0.00—50.00 Avg dose post-delivery (mg) 5669 (98.97) Median (interquartile range) 9.21 (4.00—16.00) Range 0.00—53.57 Avg dose exposure (mg) 5669 (98.97) Median (interquartile range) 14.22 (9.94—16.00) Range 0.14—53.57 Total days buprenorphine before delivery (method 3) 5621 (98.13) Median (interquartile range) 62.00 (30.00—77.00) Range 0.00—90.00 Total days buprenorphine after delivery (method 3) 5621 (98.13) Median (interquartile range) 30.00 (13.00—40.00) Range 0.00—42.00 Total days supplied buprenorphine 5621 (98.13) Median (interquartile range) 89.00 (50.00—111.00) Range 1.00—132.00 Avg dose BUP pre-delivery (mg) 5621 (98.13) Median (interquartile range) 14.49 (8.00—16.00) Range 0.00—35.42 Avg dose BUP post-delivery (mg) 5621 (98.13) Median (interquartile range) 9.14 (4.00—16.00) Range 0.00—42.67 Avg dose BUP exposure (mg) 5621 (98.13) Median (interquartile range) 14.15 (9.79—16.00) Range 0.14—42.67 Combined pain : Yes 5728 (100.00) 4537/5728 (79.21) Schizophrenia or personality disorder : Yes 5728 (100.00) 426/5728 (7.44) Alcohol or other substance use : Yes 5728 (100.00) 2704/5728 (47.21) Benzodiazepine or anticonvulsant use : Yes 5728 (100.00) 906/5728 (15.82) Maternal morbidity : Yes 5728 (100.00) 470/5728 (8.21) Anxiety and depression combined : Yes 5728 (100.00) 2542/5728 (44.38) Back pain : Yes 5728 (100.00) 2388/5728 (41.69) Depression : Yes 5728 (100.00) 2173/5728 (37.94) Bipolar disorder : Yes 5728 (100.00) 618/5728 (10.79) Other substance use : Yes 5728 (100.00) 2582/5728 (45.08) Tobacco use : Yes 5728 (100.00) 4105/5728 (71.67) Med NSAIDS : Yes 5728 (100.00) 3468/5728 (60.54) Schizophrenia psychotic disorders : Yes 5728 (100.00) 318/5728 (5.55) Anxiety : Yes 5728 (100.00) 1048/5728 (18.30) Med benzodiazepine use : Yes 5728 (100.00) 599/5728 (10.46) Maternal morbidity : Yes 5728 (100.00) 470/5728 (8.21) Dental pain : Yes 5728 (100.00) 229/5728 (4.00) Alcohol use disorder : Yes 5728 (100.00) 410/5728 (7.16) Med anticonvulsant use : Yes 5728 (100.00) 367/5728 (6.41) Med muscle relaxant use : Yes 5728 (100.00) 280/5728 (4.89) Personality disorder : Yes 5728 (100.00) 183/5728 (3.19) Fibromyalgia : Yes 5728 (100.00) 303/5728 (5.29) CDC SVI overall percentile ranking of all 4 themes 5363 (93.63) Median (interquartile range) 0.57 (0.36—0.79) Range 0.00—1.00 N is the number of non-missing value. 1Kruskal-Wallis. 2Pearson. 3Wilcoxon.
8.1.1 Time to event for overdose and death
| n | missing | distinct | Info | Mean | pMedian | Gmd | .05 | .10 | .25 | .50 | .75 | .90 | .95 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 76 | 0 | 72 | 1 | 187.1 | 190 | 106.9 | 18.75 | 46.00 | 123.75 | 210.50 | 268.50 | 299.50 | 308.50 |
| n | missing | distinct | Info | Mean | pMedian | Gmd | .05 | .10 | .25 | .50 | .75 | .90 | .95 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 20 | 0 | 20 | 1 | 165.2 | 163.5 | 118.4 | 18.15 | 33.40 | 58.75 | 174.50 | 262.50 | 280.10 | 290.90 |
Value 2 19 35 45 52 61 128 140 156 171 178 181 217 240
Frequency 1 1 1 1 1 1 1 1 1 1 1 1 1 1
Proportion 0.05 0.05 0.05 0.05 0.05 0.05 0.05 0.05 0.05 0.05 0.05 0.05 0.05 0.05
Value 261 267 275 279 290 308
Frequency 1 1 1 1 1 1
Proportion 0.05 0.05 0.05 0.05 0.05 0.05
For the frequency table, variable is rounded to the nearest 0
| n | missing | distinct | Info | Mean | pMedian | Gmd | .05 | .10 | .25 | .50 | .75 | .90 | .95 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 56 | 0 | 54 | 1 | 195 | 199.8 | 103 | 24.75 | 64.50 | 129.50 | 216.00 | 270.25 | 301.50 | 310.00 |
Survival Analysis
8.2 Kaplan Meier Plot
Call: survfit(formula = Surv(days.to.event, outcome.bin) ~ 1, data = moud18)
n events median 0.95LCL 0.95UCL
[1,] 5728 76 NA NA NA
Min. 1st Qu. Median Mean 3rd Qu. Max.
2.0 120.0 208.0 186.9 270.0 323.0 | time | probability |
|---|---|
| 2 | 0.9998254 |
| 7 | 0.9996508 |
| 8 | 0.9994763 |
| 18 | 0.9993017 |
| 19 | 0.9991271 |
| 27 | 0.9989525 |
| 35 | 0.9987779 |
| 45 | 0.9986034 |
| 47 | 0.9984288 |
| 52 | 0.9982542 |
| 61 | 0.9980796 |
| 63 | 0.9979050 |
| 66 | 0.9977304 |
| 69 | 0.9975559 |
| 97 | 0.9973813 |
| 110 | 0.9972067 |
| 111 | 0.9970321 |
| 112 | 0.9968575 |
| 120 | 0.9966830 |
| 125 | 0.9965084 |
| 128 | 0.9963338 |
| 131 | 0.9961592 |
| 138 | 0.9958101 |
| 140 | 0.9956355 |
| 144 | 0.9954609 |
| 147 | 0.9952863 |
| 156 | 0.9951117 |
| 166 | 0.9949372 |
| 171 | 0.9947626 |
| 175 | 0.9945880 |
| 177 | 0.9944134 |
| 178 | 0.9942388 |
| 181 | 0.9940642 |
| 182 | 0.9938897 |
| 184 | 0.9937151 |
| 188 | 0.9935405 |
| 208 | 0.9933659 |
| 213 | 0.9931913 |
| 215 | 0.9930168 |
| 217 | 0.9926676 |
| 220 | 0.9924930 |
| 222 | 0.9923184 |
| 223 | 0.9921439 |
| 228 | 0.9919693 |
| 229 | 0.9917947 |
| 235 | 0.9916201 |
| 239 | 0.9914455 |
| 240 | 0.9910964 |
| 246 | 0.9909218 |
| 258 | 0.9907472 |
| 261 | 0.9905726 |
| 265 | 0.9903980 |
| 267 | 0.9902235 |
| 268 | 0.9900489 |
| 270 | 0.9898743 |
| 271 | 0.9896997 |
| 274 | 0.9895251 |
| 275 | 0.9893506 |
| 279 | 0.9891760 |
| 287 | 0.9890014 |
| 289 | 0.9888268 |
| 290 | 0.9886522 |
| 295 | 0.9884777 |
| 296 | 0.9883031 |
| 298 | 0.9881285 |
| 301 | 0.9879539 |
| 302 | 0.9877793 |
| 304 | 0.9876047 |
| 308 | 0.9874302 |
| 310 | 0.9870810 |
| 316 | 0.9869064 |
| 319 | 0.9867318 |
| 323 | 0.9867318 |
Multivariable Cox PH model
8.2.1 Linear continuous terms
Effects Response: Surv(days.to.event, outcome.bin) | |||||||
| Low | High | Δ | Effect | S.E. | Lower 0.95 | Upper 0.95 | |
|---|---|---|---|---|---|---|---|
| Year of delivery | 2016 | 2018 | 2 | 0.32390 | 0.15410 | 0.02183 | 0.6260 |
| Hazard Ratio | 2016 | 2018 | 2 | 1.38300 | 1.02200 | 1.8700 | |
| Total days supplied MOUD (method 3) | 1 | 31 | 30 | -0.26840 | 0.08350 | -0.43200 | -0.1047 |
| Hazard Ratio | 1 | 31 | 30 | 0.76460 | 0.64920 | 0.9006 | |
| Age at delivery | 27 | 31 | 4 | -0.04082 | 0.10860 | -0.25370 | 0.1721 |
| Hazard Ratio | 27 | 31 | 4 | 0.96000 | 0.77590 | 1.1880 | |
| Number of Gestation weeks | 39 | 37 | -2 | 0.09981 | 0.09263 | -0.08174 | 0.2814 |
| Hazard Ratio | 39 | 37 | -2 | 1.10500 | 0.92150 | 1.3250 | |
| Route of delivery --- Cesarean:Vaginal | 2 | 1 | 0.18350 | 0.24580 | -0.29820 | 0.6652 | |
| Hazard Ratio | 2 | 1 | 1.20100 | 0.74220 | 1.9450 | ||
| Combined pain --- No:Yes | 2 | 1 | 0.26780 | 0.27150 | -0.26430 | 0.8000 | |
| Hazard Ratio | 2 | 1 | 1.30700 | 0.76780 | 2.2250 | ||
| Alcohol or other substance use --- Yes:No | 1 | 2 | 0.06777 | 0.23750 | -0.39760 | 0.5332 | |
| Hazard Ratio | 1 | 2 | 1.07000 | 0.67190 | 1.7040 | ||
| Benzodiazepine or anticonvulsant use --- Yes:No | 1 | 2 | 0.22720 | 0.28610 | -0.33350 | 0.7879 | |
| Hazard Ratio | 1 | 2 | 1.25500 | 0.71640 | 2.1990 | ||
| Anxiety and depression combined --- Yes:No | 1 | 2 | 0.74930 | 0.25280 | 0.25380 | 1.2450 | |
| Hazard Ratio | 1 | 2 | 2.11600 | 1.28900 | 3.4720 | ||
| Maternal morbidity --- Yes:No | 1 | 2 | -0.15200 | 0.46710 | -1.06800 | 0.7636 | |
| Hazard Ratio | 1 | 2 | 0.85900 | 0.34380 | 2.1460 | ||
Wald Statistics for Surv(days.to.event, outcome.bin) | |||
| χ2 | d.f. | P | |
|---|---|---|---|
| Year of delivery | 4.41 | 1 | 0.0358 |
| Total days supplied MOUD (method 3) | 10.33 | 1 | 0.0013 |
| Age at delivery | 0.14 | 1 | 0.7069 |
| Route of delivery | 0.56 | 1 | 0.4553 |
| Number of Gestation weeks | 1.16 | 1 | 0.2809 |
| Combined pain | 0.97 | 1 | 0.3239 |
| Alcohol or other substance use | 0.08 | 1 | 0.7752 |
| Benzodiazepine or anticonvulsant use | 0.63 | 1 | 0.4268 |
| Anxiety and depression combined | 8.78 | 1 | 0.0030 |
| Maternal morbidity | 0.11 | 1 | 0.7449 |
| TOTAL | 39.60 | 10 | <0.0001 |
`
8.2.2 Univariable HR
Effects Response: Surv(days.to.event, outcome.bin) | |||||||
| Low | High | Δ | Effect | S.E. | Lower 0.95 | Upper 0.95 | |
|---|---|---|---|---|---|---|---|
| Total days supplied MOUD (method 3) | 1 | 31 | 30 | -0.293 | 0.08475 | -0.4591 | -0.1269 |
| Hazard Ratio | 1 | 31 | 30 | 0.746 | 0.6318 | 0.8808 | |
Wald Statistics for Surv(days.to.event, outcome.bin) | |||
| χ2 | d.f. | P | |
|---|---|---|---|
| Total days supplied MOUD (method 3) | 11.95 | 1 | 0.0005 |
| TOTAL | 11.95 | 1 | 0.0005 |
9 Sensitivity analysis shift-forward
| N | Overall | |
|---|---|---|
| (N=7472) | ||
| Total days supplied MOUD (method 3) | 7472 (100.00) | |
| Median (interquartile range) | 89 (47—112) | |
| Range | 1—132 | |
| MOUD days exposure shifted approach | 7472 (100.00) | |
| Median (interquartile range) | 92 (50—115) | |
| Range | 1—132 |
N is the number of non-missing value. 1Kruskal-Wallis.
2Pearson. 3Wilcoxon.
9.1 Survival Analysis
Multivariable Cox PH model
Linear continuous terms
Effects Response: Surv(days.to.event, outcome.bin) | |||||||
| Low | High | Δ | Effect | S.E. | Lower 0.95 | Upper 0.95 | |
|---|---|---|---|---|---|---|---|
| Year of delivery | 2016 | 2018 | 2 | 0.407700 | 0.09674 | 0.21810 | 0.59740 |
| Hazard Ratio | 2016 | 2018 | 2 | 1.503000 | 1.24400 | 1.81700 | |
| MOUD days exposure shifted approach | 1 | 31 | 30 | -0.181000 | 0.06375 | -0.30600 | -0.05608 |
| Hazard Ratio | 1 | 31 | 30 | 0.834400 | 0.73640 | 0.94550 | |
| Age at delivery | 27 | 31 | 4 | -0.092560 | 0.07950 | -0.24840 | 0.06326 |
| Hazard Ratio | 27 | 31 | 4 | 0.911600 | 0.78010 | 1.06500 | |
| Number of Gestation weeks | 39 | 37 | -2 | 0.072490 | 0.07386 | -0.07227 | 0.21720 |
| Hazard Ratio | 39 | 37 | -2 | 1.075000 | 0.93030 | 1.24300 | |
| Route of delivery --- Cesarean:Vaginal | 2 | 1 | -0.007594 | 0.19320 | -0.38620 | 0.37100 | |
| Hazard Ratio | 2 | 1 | 0.992400 | 0.67960 | 1.44900 | ||
| Combined pain --- No:Yes | 2 | 1 | 0.233600 | 0.19800 | -0.15430 | 0.62160 | |
| Hazard Ratio | 2 | 1 | 1.263000 | 0.85700 | 1.86200 | ||
| Alcohol or other substance use --- Yes:No | 1 | 2 | 0.331500 | 0.18540 | -0.03190 | 0.69490 | |
| Hazard Ratio | 1 | 2 | 1.393000 | 0.96860 | 2.00400 | ||
| Benzodiazepine or anticonvulsant use --- Yes:No | 1 | 2 | 0.354000 | 0.22390 | -0.08485 | 0.79290 | |
| Hazard Ratio | 1 | 2 | 1.425000 | 0.91870 | 2.21000 | ||
| Anxiety and depression combined --- Yes:No | 1 | 2 | 0.637700 | 0.20080 | 0.24420 | 1.03100 | |
| Hazard Ratio | 1 | 2 | 1.892000 | 1.27700 | 2.80500 | ||
| Maternal morbidity --- Yes:No | 1 | 2 | -0.001804 | 0.37690 | -0.74050 | 0.73690 | |
| Hazard Ratio | 1 | 2 | 0.998200 | 0.47690 | 2.08900 | ||
Wald Statistics for Surv(days.to.event, outcome.bin) | |||
| χ2 | d.f. | P | |
|---|---|---|---|
| Year of delivery | 17.74 | 1 | <0.0001 |
| MOUD days exposure shifted approach | 8.06 | 1 | 0.0045 |
| Age at delivery | 1.36 | 1 | 0.2439 |
| Route of delivery | 0.00 | 1 | 0.9687 |
| Number of Gestation weeks | 0.97 | 1 | 0.3259 |
| Combined pain | 1.39 | 1 | 0.2380 |
| Alcohol or other substance use | 3.20 | 1 | 0.0738 |
| Benzodiazepine or anticonvulsant use | 2.50 | 1 | 0.1137 |
| Anxiety and depression combined | 10.08 | 1 | 0.0015 |
| Maternal morbidity | 0.00 | 1 | 0.9962 |
| TOTAL | 61.20 | 10 | <0.0001 |
9.1.1 Univariable HR
Effects Response: Surv(days.to.event, outcome.bin) | |||||||
| Low | High | Δ | Effect | S.E. | Lower 0.95 | Upper 0.95 | |
|---|---|---|---|---|---|---|---|
| MOUD days exposure shifted approach | 1 | 31 | 30 | -0.2115 | 0.06532 | -0.3395 | -0.08345 |
| Hazard Ratio | 1 | 31 | 30 | 0.8094 | 0.7121 | 0.91990 | |
Wald Statistics for Surv(days.to.event, outcome.bin) | |||
| χ2 | d.f. | P | |
|---|---|---|---|
| MOUD days exposure shifted approach | 10.47 | 1 | 0.0012 |
| TOTAL | 10.47 | 1 | 0.0012 |
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